Real Food for Fertility: Behind the Book (Episode 508)

Full Transcript: Episode 508

Lisa Hendrickson-Jack: This is the Fertility Friday podcast, episode number 508.

Today I have some exciting news to share. Today is officially the release date of my new book, Real Food for Fertility. Real Food for Fertility is a culmination of nearly three years of researching, writing, editing, more researching, more writing, more editing with my friend and colleague Lily Nichols. And we are just so thrilled to be able to share this book with everybody. Today, we have launched this book on Valentine’s Day, which was Lily’s idea, which I think is just so wonderfully fitting. Fertility, love, making babies, all the things in line with our official release date. Lily and I wanted to do something special for our fans, for our community. And so we decided to team up for today’s episode where we tell all about what was happening behind the scenes, how this project came about, how we met and became friends, and also a little bit of behind the scenes on the research process and how we selected certain topics and how we structured the book, how we decided what to write. And we actually reached out to our audiences on social media, and we’ve incorporated some of the questions from you, from the audience. So I hope that you enjoyed today’s episode. I think that it’s really fun. Lily and I had a great time having this conversation. It was nice after all the hard work is done to sit back and chat about how everything came about. A nice trip down memory lane, if you will. And we also share a little bit more information about the book and what you can expect from the book. And so because we have so much to say and we took so much time and effort putting into creating this amazing resource for all of you, we decided to have two separate episodes. So today’s episode is more of a behind-the-scenes tell all, which I think you’ll really, really enjoy. And then on Friday I’m releasing a second episode with Lily where we get into more of the specific nitty-gritty. So we chose to talk a little bit about protein, a little bit about PCOS specifically. We get into a really good conversation about nutrition and the nutritional approach that we take within Real Food for Fertility. And so we highlight some of the specifics for PCOS because it’s a really good example of the importance of regulating blood sugar and the importance of deep nutrition and balancing macronutrients. But we also talk about how that applies across the board regardless of whether or not a person has PCOS. So you can expect that for our episode on Friday.

So for those of you who don’t know, I’ll just quickly share a little bit about Lily. Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. Her work is known for being research-focused, thorough, and critical of outdated dietary guidelines. She is the founder of the Institute for Prenatal Nutrition, co-founder of the Women’s Health Nutrition Academy, and the author of three books — Real Food for Pregnancy, Real Food for Gestational Diabetes, and of course our new book, Real Food for Fertility. Lily’s bestselling books have helped tens of thousands of mamas and babies, are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally. So without further ado, let’s go ahead and jump into today’s episode featuring Lily and myself talking about our new book, Real Food for Fertility.

All right, well I’m super excited to be here today with Lily Nichols. Lily and I have been friends for a long time. I think unbeknownst to many of our fans, we’re discovering. And we’re here today. We thought it would be fun to do a tell-all behind-the-scenes episode on our brand-new book. And I’m publishing this episode on release day. So this is a really fun day for us. It’s been in the making for several years at this point. So I’m really excited for today’s episode. Welcome back to the show, Lily. This is probably your seventh appearance. I feel like I counted at one point, and so you are the guest that has been featured the most times on the show.

Lily Nichols: Yay! Which feels funny because we talk all the time. So I’m like, what am I doing on your podcast? Yeah, what are we talking about today?

Lisa: Well, so we both posted in our respective social media channels a couple of questions — or we posted an invitation to ask us questions, what people would want to know. So we’re incorporating some of those questions along with some of our own thoughts and then we’re kind of winging it. So whatever comes out, which I think will make for a really, really fun episode. So I read your bio already. I think anyone who’s listened to the podcast for a long time is familiar with her work. There’s so much overlap in our audiences. But there are still people who are a little bit less familiar or who haven’t had a chance to meet you yet. So anything you’d like to share about yourself in a nutshell for anybody who isn’t aware of all of your work?

Lily: Sorry, I’m just laughing. That’s like a really funny way to intro me. Yeah, so my work really centers around nutrition and the childbearing years. And I think to date most people associate me with nutrition for pregnancy and gestational diabetes because those are the topics of my other two books. And yeah, I think my work sort of centers around looking at how our guidelines are set and why our nutrition guidelines are what they are, and where there are gaps in the research. Like, okay, these guidelines are sometimes 20, 30 years old, or maybe like they’ve been so-called updated, but they haven’t really changed much in the last couple of decades. And yet here’s all this data we have showing how we could improve pregnancy outcomes by implementing these things. So I’ve long wanted to write more about preconception nutrition because the more you dive into pregnancy nutrition, there’s a whole lot of challenges and complications that actually have their roots all the way back to preconception health — a big part of the reason that you and I decided to team up and write this new book together. So yeah, that’s me in a nutshell.

Lisa: Well, I want to ask a couple other questions to tease out more because we need to share more of the amazingness, of course. And it’s been a while since you’ve been on the podcast, so share with us a little bit just about your previous two books and particularly the impact that they’ve had even on international policy. I feel like that’s something that maybe people don’t know.

Lily: Yeah, so my first book, Real Food for Gestational Diabetes, I wrote after being a clinician, but also in the public policy area with the state of California’s diabetes and pregnancy program, to kind of outline what I found worked better than the nutritional guidelines for managing the condition. And I wrote that book with no expectation that it would really do anything of importance other than just provide the data behind my recommendations and help outcomes. I was getting really frustrated hearing from colleagues who kept recommending the same things and then having clients quote-unquote fail diet therapy, or hearing from women themselves. I was in a lot of gestational diabetes Facebook groups at the time and just the terrible advice they were given by their clinicians, which was making their condition worse and necessitating them to go on medication and insulin when they probably didn’t really need it. They just needed to shift their diet and lifestyle in a different way than they had been advised. I mean, that’s the whole reason that I wrote the book. But within about a year of when it was released — and by the way, I didn’t know what I was doing. I had no marketing plan. I didn’t talk about the book before it was released at all. I just like released it and announced it to my email list. It was no launch, no marketing until after the fact. And it ended up in some Twitter thread. There was a guy in the Czech Republic who had a colleague who worked at the policy level for gestational diabetes. And she ended up with a copy of my book on her desk. And that is ultimately what influenced the shift in their country-wide dietary guidelines for gestational diabetes. So originally they had — you need to consume a minimum of 200 grams of carbohydrates per day if you have gestational diabetes — and they actually reversed it to the opposite. So it’s now a maximum of 200 grams of carbohydrates per day. And they have since reported significant improvements in outcomes — fewer babies who are born macrosomic or larger than expected, lower rates of neonatal hypoglycemia, 50% or more reduction in the needs for prescribing insulin or blood sugar-lowering medication. And this mirrors exactly the kind of stats that we saw in practice in California. So yeah, that’s really cool that that had that impact — very unexpected. And then Real Food for Pregnancy came about because people started asking me, hey, I like your book on gestational diabetes, but do you have anything for general pregnancy? And I was like, just follow the gestational diabetes book. It’s basically the same thing, you just don’t have to be as obsessive about your blood sugar. But those same principles really apply to everybody. And finally it hit critical mass after I had my first baby and had navigated the system, which was a mess, and was like, wow, there is really so much more that needs to be said. There are so many myths that are perpetuated. And it took me a lot of time to like dive in. So all the things that I had researched during my pregnancy and then having gone through early postpartum — I was like, okay, we need to write a book. We’re just gonna be debunking all these myths. I have to put in a chapter on postpartum. And yeah, so here we are today, where this snowballs into our book which is 30% longer than Real Food for Pregnancy, covers so many different topics, so much different data. I can’t say that I’ll ever write another book because we’re at that stage where you don’t ever want to write another book again. So we’ll see where this ends up.

Lisa: Yeah, well I feel like that ties us neatly into one of the great questions that we got from our audiences, which is how did we meet? Because it was somewhere between book one and book two. So I don’t know if you want to jump into that.

Lily: Yeah, so after I published Real Food for Gestational Diabetes with zero marketing plan, I was like, you know what, I think a good way to market this book would be to go on podcasts. And this is 2015, so podcasts were not super popular — not like they are now. And at that time I think your podcast was like one of maybe three that I found. I was looking for podcasts that would make sense for me to pitch. And just looking through your episodes and listening to a couple, I was like, oh she’s really good, I like this content. And I think we could kind of tie this into something that’d be useful to your audience. So I cold-pitched you over email to see if you wanted to have me on your podcast. And you wanted to see my book first. You asked for a paperback copy of the book. And the only other person who had asked me to mail them a paperback copy of the book was Robb Wolf. Like Robb Wolf had me on his podcast, which was a really big deal at the time. But it was only you two who had asked for a paperback copy. And you’re in Canada, so I’m like, man, it’s going to cost me like 30 or 40 bucks and she still might say no. But oh well, I’ll mail it — cost of doing business. And yeah, I’m glad we did because look at us now.

Lisa: Well, yeah, I remember that. And it was very very early on. We’ll link the episode to the show notes page, but if I remember correctly it was somewhere like episode 15 or episode 20 — you were one of my very first. I’m so embarrassed — I don’t ever listen to my episodes like ever, but I would be extremely embarrassed to listen to that one. So have fun. Well, you know what’s interesting — I thought that myself, because of course I’ve been podcasting since 2014. So I went back a few years ago and actually listened to like episode one just out of curiosity, thinking it was just going to be awful. And I was like, oh man, I’m saying the same stuff that I was saying then. And so I wouldn’t be surprised if the episode is fire because you had just recently written the book on gestational diabetes, you were on fire for the topic just as you are now.

Lily: I am definitely saying mostly the same things, just citing new data.

Lisa: Yeah. But I remember getting your book and like devouring it and loving it. I still have the copy you sent me on my bookshelf. And yeah, so I was really excited to interview you. And the rest, they say, is history. It’s interesting because then we kind of — we’ve known each other for quite a while and I had you on the podcast several times. So we were always really friendly. And I think there was that moment — so not a lot of people know that we actually wrote our books at the same time. So from what I remember, I interviewed you and I was trying to convince you to write Real Food for PCOS. And you were kind of firmly like no, I’m not doing that. But you were like, I think it’s time for me to write Real Food for Pregnancy. And I was like, well, I want to write a book about the menstrual cycle. And I jokingly was like, well, we should just be book buddies and write our books at the same time. And I remember that you were kind of like haha, but then like I swear it was like the next day you were like okay, let’s do it. And I was like, oh — oh crap, we’re writing a book.

Lily: Yeah. I think our interview was sometime in like maybe November, it was in the winter, and then I think we started writing and meeting weekly sometime early the next year. So yeah. So people don’t know this, but we met almost every single week without fail. I think it took me about 14 months or so from start to finish for Real Food for Pregnancy, which seems so short now. But we met every single week. I was writing Real Food for Pregnancy, you were writing The Fifth Vital Sign. And we reviewed each other’s manuscripts, gave feedback on different sections. I mean, we were very involved in each other’s manuscripts. And just sharing interesting research that we’d find along the way, cheering each other on. You really do need accountability because it’s very easy to start a project and not finish unless you’re like extremely motivated. Yeah.

Lisa: And it took me about two years to write the book because you had just had your first son when you were writing Real Food for Pregnancy. Like you said, he was 10 months old when you started. And I had my two sons already and I think you did too. Yes, I definitely did. But we made it happen. And that consistent accountability and friendship really helped to bring it all to life. So this was all going on behind the scenes unbeknownst to anybody. I think it’s wild how long we’ve known each other. And we’ve met in person once — which will change sometime this year.

Lily: Yes, we have to get to LA to record the audiobook at some point. People are already asking and I’m like, we will. But we insist on reading it ourselves. I mean, I hear feedback all the time — you recorded your own audiobook for The Fifth Vital Sign, I recorded my own for Real Food for Pregnancy. And it’s surprisingly hard to read what you write. But it also I feel like it’s so important that the author is reading it because you can actually give emphasis to the right things with your tone of voice. Some random person reading it would probably mispronounce a whole bunch of words. So we will do that, yes. It’s coming. It will happen.

Lisa: That’s always the next question — when’s the audiobook? Because I, obviously as a podcaster, but also as an avid audiobook listener — I’m a busy mom with a business and all the things. And so honestly if it wasn’t for audiobooks I would read significantly less. I’m a big fan of audiobooks. And an audiobook is not a podcast. It requires a totally different level. I took it to a different level when I recorded the audiobook for The Fifth Vital Sign — a different level of editing where we’re removing breaths and stuff so that the audio sounds really, really crisp and clear. We want it done right. And audio books, because of the length of Real Food for Fertility — I mean it’s over 170,000 words. As our editors have said, like this is three or four books worth of words. This is long. We’re probably going to need to spend two whole weeks possibly in a studio.

Lily: Yeah. Well, and we don’t say this to be braggy — the feedback I think consistently that we’ve had is yes it’s a long book, but there’s nothing in there that doesn’t need to be. It’s just a big topic and we’re combining so much. I know for a lot of our listeners, it’s like two worlds are colliding. I didn’t even know you were friends. But it really is — we’re bringing in the nutritional piece, which is incredible. I mean, the level of research. But when we also then add in the fertility awareness piece, egg and sperm quality — we’ve had such positive feedback on just the depth of the work. So it is it is long but not unnecessarily so. We pained ourselves on the editing.

Lisa: Okay, let’s move on to some other questions. I feel like I’ve answered this other one — whose idea was it to collaborate and write a book together? How did the project come about?

Lily: I don’t remember the moment because it was kind of mutual. We got together — what early 2020, pre-COVID — and we were like, yeah, we should write this book. And then like COVID nonsense and then it took a little while to get going. We were outlining things while navigating a world in chaos and no childcare, no school, all the craziness. But I feel like it was sort of a mutual like yeah we should write this book together. And once we got a really solid outline together and could see how we would sort of parse out the writing of different topics and which chapters would be collaborative — we kind of went from there. I mean for both of us it’s not our first book. It’s our third book. We’re not green to this process. So I feel like our outline was pretty solid. That said, outlines change. So we kept revisiting the outline, changing things around. Once you get into the weeds with something you’re like, well, do I need to talk about it here? Like where’s the main place I need to cover this topic in the book? Because of course there’s overlap all over the place. And so we did revisit that. But yeah, I feel like it was sort of mutual — we’re like, yeah, we are gonna do this. Are we gonna do this? I think we’re gonna do this. Are we actually doing this? Are we really? Yeah.

Lisa: Well, and for me from my perspective — for all of my clients who are listening to this episode — I recommend your book for all of the clients, and especially for my conception clients or my preconception clients. Those who are actively trying to conceive or planning to in the future. But then I have all these other clients who are actually not actively trying to conceive but are just looking to support hormonal health. And it’s similar to what you said about how when people were asking for the pregnancy book you were like, okay, just read this book, it’s like the same stuff. That was how I was approaching it — this is really the foundational nutrition plan that you should be following if you want to balance hormones. So it just felt like a natural fit.

Lily: Totally. And likewise, when anybody asked me about preconception I’d be like, well, read Real Food for Pregnancy. But also get The Fifth Vital Sign, because you need to understand what your cycle is telling you about your health and you need to understand your fertile days so you know when to time sex for conception. You need both. So I think we are both recommending each other’s resources as a complementary pair. And then it’s just — there’s so much that’s new. There’s so much new information. So many topics that were not covered. I mean — I hope it’s okay to share this — you wanted to write a whole book about sperm quality and instead you created a chapter. I remember this. We have a very detailed chapter on sperm quality in Real Food for Fertility. I mean so much so that I’m like, Lisa, we’ve got to pare this down. But you know what — the women are going to read it and then probably relay the key points or badger their partners to finally pick it up and read that chapter. They only have to read one chapter out of the book, okay? Like come on. So it’s a beefy one. Yes.

Lisa: Well, I think you touched on something because what I found — we’ve joked the whole time like you’re the only person I could write a book with. We’re so well matched in terms of our obsession with research, taking it to levels that it doesn’t need to go to. But we did. And there are areas where you would go into the weeds about certain topics because you’re on the nutrition side getting these very detailed questions from clinicians about the controversial vegetarian chapter, or the specific amino acids that are potentially missing or conditionally essential in some situations and not others. So you’re getting all of these questions that I am not getting, and therefore you’re going into a lot of research depth that I wouldn’t even think to in those areas. And I think similarly in some of my sections when I’m going into the weeds about AMH or going into the weeds about sperm quality. And I feel like by working together we were able to go into those areas that we needed to but also pull back when it’s like — do you really need six studies in this one paragraph, Lisa? Like do you really need six studies supporting one sentence? What was good about having each other was that neither of us are subject matter experts in the other person’s subject. And so if we were reading a section of the other person’s and we’re like, wait, these statistics seem to be either confusing or overlapping or repetitive — can we just focus on what point are you trying to make? I think we did a lot of that with each other’s sections to really streamline the writing.

Lily: Yes. It’s so easy just — in both of our subject matters it’s very easy to get lost in the weeds and lose the point. You really have to keep it quite focused. What’s the takeaway that you want the reader to have? And I feel like it was good having another person’s perspective to be like — you know, I had all that extra stuff on CoQ10 that didn’t need to be there. I went down a rabbit hole and you’re like, well that’s interesting, but it loses the plot and it just confuses people. So we kind of massaged each other’s sections that seemed to be missing the mark to bring it back to where it needed to be. And at the same time compromising, because sometimes we just had to agree to disagree. That’s part of the compromise of co-authorship — you’re like, well, I wouldn’t title that section that, or I wouldn’t even include that section, but it’s your responsibility, and at the end of the day it’s probably fine. And really at the end of the day when we see the final printed book we’re like, yeah, it is fine. All the back-and-forth about titling the subheading or making this an H1 instead of an H2 — doesn’t actually matter. But it seems important when you’re in the weeds because book writing is just such a detailed process.

Lisa: Well I keep thinking of that phrase — iron sharpens iron. And I really feel like that’s true in this case because the end result is something that neither of us could have done on our own to the same degree. Neither of us are the subject matter expert in the other one’s field. So I’m super thrilled. It’s been such an interesting process and we’re still friends.

Lily: We are still friends. I think that speaks to our individual nervous system regulation. Even when we had disagreements we were able to solve it amicably. And also, more importantly, when one person is spinning out because something’s going wrong or like some contractor didn’t do their job right and now we have to go fix it — which was a repetitive theme in this whole process — we could talk each other off the ledge. And we did a lot of that. Like half the process was talking each other off the ledge. I’m like, oh my gosh this isn’t working. And you’re like, it’s going to be okay.

Lisa: Exactly. It was quite the process. Three years — that’s obviously more than twice as long as it took you to write Real Food for Pregnancy. But also this book is so much longer. And the editing process was so much more involved. And then the formatting process somehow was so much more involved. Every part of the process was unexpectedly more time-consuming. And that is kind of a theme with book writing as a whole — it just takes a long time.

So by this point we’ve had some feedback from our advanced readers. One of the things I’ve seen written a lot about it is just like — wow, so much time and dedication went into it. It really did. I feel like this book was not just this thing we were trying to put out — or it wouldn’t have taken us three years. It’s very near and dear to both of our hearts. I know for myself this is the book I could have used when I was in my early 20s — not just to prepare me for pregnancy, but to help me with just hormone balancing and having a deeper understanding. This book comes out of our obsessive need for research but also our personal experiences as mothers and women, our professional experiences with clients. We both have practitioner programs. So the purpose of this book, at least from my perspective, is to really provide that resource that women deserve. And that’s why I’m so obsessive about the research. I really feel strongly that I don’t want to be another person that’s just — I have this credential, trust me because I said so, don’t ask me any questions. I don’t want to be that person. With the book, it gives that opportunity for you to see our perspectives but to see that they’re informed by what the research has to say. And we’re super critical about that. This is what women deserve and this is the only way we’re going to improve — whether it’s birth outcomes, fertility, just the level at which women are informed about their bodies and their health.

Lily: Anyone who reads the book can see that it’s more than just something we did on a weekend. I don’t think you throw together 2,600-plus in-text citations in a weekend. In fact, that was one of the questions that I got on my Instagram when I asked people — how many studies did you review and how long did that take? When I say there are over 2,600 in-text citations, that means endnotes, footnotes — the numbers at the end of a sentence where we’re citing where that data came from. And oftentimes those numbers correspond to more than just a single study. Some of those are 2, 3, 4, 5, 10. I would estimate we had to collectively have reviewed over 10,000 studies. I mean, because I sometimes would sort through five or six studies before I found one on a topic that was worth citing. There are a lot of studies that are poorly done, that are extremely biased. And this is what happens before you’re writing — sometimes you will spend days reading research before you write a single sentence. And sometimes a paragraph will take you 20 hours between the research and the writing. People have no idea the amount of time it takes to put this together. Both of us launched our practitioner training programs in the midst of writing this book. A book in this sort of professional health space is a thousand times harder than putting together an online program or a course — even a practitioner program — when your practitioner programs all cite and source just like yours does with a research library and stuff. It’s nothing compared to a book, especially the type of book we’re trying to write, because you’re putting something out there that’s going to hopefully stand the test of time.

Lisa: I was trying to estimate just how many hours it took me to write the book. I would think at least a thousand to 2,000 hours or something like that. And what you said about the process of writing — I think that’s a really interesting point for anyone who is interested in how we did it. Because when I think about some of the sections that I was writing — before I write a word, I would go and pull a whole bunch of studies on that particular topic, read through them, review them. I have this intense system where I download all the studies and keep them in a folder. I have a ridiculous folder with I don’t even know how many studies are in there — 20, 30,000 at this point. And so I’m going through, highlighting, reading, making sure that every point is covered. And so on a chapter-by-chapter basis there are anywhere from — some chapters have a few — but our main chapters have anywhere from 50 to 250 citations a piece. And those are the numbers, not necessarily the total number of papers, because each number would have multiple. Our editor was like, why do you have so many citations? It’s one little line of text — what is wrong with you?

So for our readers — they might get their copy of the book and then wonder why we made the decision we did about the citations. The book itself is around 500 pages, including all the front matter and back matter. And as we were writing and seeing how many citations we had, we had to make an editorial decision. Because when we prepared our PDF download, the first time our formatter formatted the references it was 300 pages. I was like, whoa — reduce the font size and line spacing, this is insane. But yeah, it’s almost 200 pages — the final formatted references. So that would have made this book over 700 pages, which for printing costs is insane. And it’s like, that’s too much to bring on an airplane. So we made that call. But we say this so that you know what went into the book. And so you can know — especially our advanced readers who are also clinicians — that they’re thrilled to have this now as a resource for clients. And having those references available really helps, because then for anything that you want to do further reading on, you are given the tools to do that. That’s one of my pet peeves when I’m reading books where the author says all these things and I want to read where they got that information. So to clarify — while we don’t have the full citation list in the book itself, we have a PDF download at realfoodforfertility.com where you can download the full 200-page reference list. And we chose to include highlighted references for each chapter so that you can see the studies that stood out the most, for those who want that general overview. But for the research nerds, yeah — we have that option as well.

So to go back to some of the great questions from our audience — some were wanting to know where we start with research, and how do you determine which studies are valid and which are not?

Lily: Yeah. I think what sets both of us apart is that we’re not truly academics in the sense that you only see research but don’t see clients. We’re also not only clinicians who just practice whatever and don’t pay attention to the research. We kind of bridge the gap a little bit. So for me, I’ve made observations over the years on certain things and then I want to go check myself and see — is that actually accurate? Is this actually what larger bodies of data are finding? Or was that just an N of one or N of five or N of ten clients that had this experience? So we kind of cross-check our clinical observations with the research. There are also times where I will do a search of terms and educate myself on a topic that I don’t know super well. What’s really challenging about researching fertility — and I think why you have so many resources that are very bland in the information they give on fertility, or you also have people who will be like oh, we don’t have research on that — is that they didn’t really do a thorough search of the literature. If you’re limiting your search on PubMed or Google Scholar — I personally prefer usually to use Google Scholar, though you get broader search results on Google Scholar and a narrower view on PubMed, so you kind of have to pick your poison depending on what you’re looking for. But if you do a search on Google Scholar for fertility nutrition, you’re not going to get all the research on fertility nutrition. You have to be really creative with your search terms. It’s especially challenging because sometimes you want to look up something like egg quality, and then you’re pulling up all these studies on animal nutrition. Sometimes egg quality is referring to a chicken’s egg quality — the nutritional profile of a chicken egg. The results can be non-specific. And that’s what I found actually the most time-consuming about the research process for this — you really did have to have an array of possible search terms. And when you found a nugget, when you found a good study, refine your search terms from that, and that might open a whole other Pandora’s box of research that none of your colleagues would ever find because they’re not spending hours and hours in their research databases. And then I will say on the accuracy and validity part — this comes with experience. The more research you read, the more able you are to very quickly point out things that are inaccurate. And Lisa and I together, with our own areas of expertise, she would maybe find something on nutrition and then run it by me and then I’d be like, oh this is messed up because — and I might find something with hormones and Lisa’s like, well, they didn’t validate any of these menstrual cycle things. So we were honestly often collaborating on — hey, do you think this paper actually is valid or worth writing about? And I don’t think people realize your level of research obsessiveness around hormones and the menstrual cycle. It’s like beyond. You are familiar with all of the fertility awareness methods and you also validate what you’ve learned from those various methods with the research. And that is something that is not typical at all in your field. So I feel like both of us are just — we are not the type of people who take a paper and we’re like, oh, this is the truth. We’re really, really critical about the information we come across, and then we’d help each other validate stuff.

Lisa: Well I think that’s — you made so many good points. You see certain trends in research. The more papers you read, the interesting thing about our approach is that it’s not like we’re just trying to find a citation. We’re not just reading one paper on the topic and saying this is the be-all and end-all. You’re kind of trying to understand the area of research and what the researchers are saying about it. Because within almost any area there are some papers that are supportive to the conclusion and others that are not. And so then you have to start asking the question — well, you have all these papers that are saying vitamin D is really helpful for this, but then you have these other papers that say that didn’t really outdo the placebo. Why? And I also think the approach that we take — because research isn’t just finding a paper that supports what you think. Research is actually trying to figure out what’s going on in the field. So from that perspective, I never elevate one paper to be the be-all and end-all.

So one of my favorite examples: when I was writing the sperm quality chapter, there was this one paper — the title was mostly related to how the typical kind of Mediterranean diet stuff is good for sperm, right? The vegetables and the fish. And there was no mention anywhere in the abstract about organ meats. So I read the abstract and I’m like, this looks interesting. I grab the full text, I’m reading the paper, and I find in the middle of the paper that the men who consumed organ meats — particularly liver — had significantly higher sperm parameters. And I feel like this is like a huge finding. It was right up there with the other stuff that they were talking about being beneficial. Yet nowhere did it make it into the abstract. So this is just to give a concrete example — if all you do is read the abstracts and you don’t actually read the whole paper and see what they actually report in their results and how it compares to what they said in their conclusion, you would be amazed at how often it doesn’t match.

Lily: Absolutely. And I found the same thing. Their finding makes perfect sense when you understand the research around vitamin A in the active form of retinol and how that impacts the production of testosterone and sperm. And so it actually makes sense. But they don’t highlight it. I found so many examples where I was just really frustrated in the research. Some of the studies that are looking broadly at diet try to paint — they have an external concept of what a healthy diet is and then they assign a score of how healthy or unhealthy the diet is and try to compare that to fertility or ovulatory function or time to conception. Those studies are really frustrating to me because often times they would put in the assumptions that of course things known to be harmful to fertility — like sugar, refined carbohydrates, trans fats, alcohol — they would put those in the bad category. Fruits and vegetables of course in the good category. But then meat, particularly red meat, usually went in the bad category. So they’re taking points away if you consume more red meat. And yet sometimes when you look more specifically at the women with the greatest ovulatory function or the shortest time to pregnancy, those were often in the women consuming the most protein including the most animal protein. But they found creative ways around not stating that in the discussion or the conclusion. For example, there was one — a study titled “Low Intake of Vegetable Protein Is Associated with Altered Ovulatory Function Among Healthy Women of Reproductive Age.” And if you just read the abstract, you would think, okay, women who eat a low amount of vegetable protein have messed up ovulatory function. But when you looked more closely at the data itself, animal protein had no negative impact on reproductive hormone levels and was not associated with ovulatory problems. And more so — when you went into the data tables where they’re giving the odds ratios for how likely consumption of this type of protein is to be associated with ovulatory issues — nuts and seeds and meat alternatives were actually associated with a greater risk of ovulatory issues, yet the title of the study was building up plant protein as the solution to ovulatory issues. And even processed meat — which in research is usually like a big no-no — was actually protective, was supportive of ovulatory function. And they just didn’t even mention it. So this is all to say that our approach to research is not just to take any individual paper as the be-all and end-all. It’s really a process of delving through information and reading enough of it to get a handle on what it really says, what’s really out there, what the trends are. This was hard to convey in editing why I have so many citations for one line sometimes. But that’s how it goes when you’re looking to really interpret because at the end of the day it’s not about proving ourselves right — it’s about understanding what the research actually shows.

Lisa: So a couple more questions. Lily, was there something you felt in your gut but found tough to back up with research?

Lily: I guess the one topic where we just don’t have the data yet — and you’ll probably agree with this — is we need a lot more research on iodine and fertility. There’s a lot of like associations with low iodine intake or low iodine status and delays to conception or greater likelihood of having ovulatory issues such as PCOS. But correct me if I’m wrong, Lisa — I don’t think there’s an intervention study on iodine supplementation in women with PCOS, right?

Lisa: No, I have not seen one specifically. It’s mostly either case study data or research that has been collected by practitioners but not necessarily published in major journals.

Lily: Yeah, so that is one area where we would have loved to really advocate more definitively. We can advocate that if you have PCOS, you explore having your iodine status measured and that can guide you to whether supplementation is helpful or not. But as a whole, the presence of any sort of cystic tissue — fibrocystic breasts, for example — we actually do have research on fibrocystic breasts and intervention with iodine treatment. But it’s an area where I wish we had more data. So we’re careful with our wording on things to not overstate what doesn’t exist. But there is certainly from our practices — you often see that women with PCOS are pretty iodine deficient. Actually, many people are iodine deficient. And it’s an area of research that I think has been controversial for a variety of reasons. But I have a gut feeling that across the board, repleting people’s iodine stores would do a lot for improving PCOS. But I don’t have an intervention study to say so. So we’re careful with our wording on that.

Lisa: And although we don’t have the human studies, there’s a lot of animal studies. That’s one of those areas that’s super frustrating because there are actually studies — many of them — where you’ll have cattle who are not ovulating. They call it anestrus, where they’re not reaching ovulation. That’s a problem because the dairy industry is a money maker and if the cows are not ovulating and lactating they’re not able to get pregnant. And there are so many of these animal studies where iodine promotes ovulation in cattle. I find these animal studies so interesting because there are these detailed lists of nutrients that the cattle need in order to have optimal fertility — the same ones we talk about. They’re just so specific on it. And the iodine is part of the conversation. I find it to be so interesting because if we can get this dialed in on the cattle — but it’s true. We have backyard chickens and it’s like the chicken food is all very carefully fortified with precise ratios of nutrients for each different stage — different feed when they’re babies, different feed when they’re laying eggs, different feed for birds raised for meat. They have it all super dialed in. But there’s also not the ethical ability to do intervention studies that deprive nutrient levels the way they used to do in animals. So it’s an area of research where we are just really limited.

Lisa: Last question on this topic — were there any new studies that shocked you?

Lily: I found it very enlightening — the research on hypothalamic amenorrhea and looking at what these women typically eat. Just to give a quick overview — this is when you’re no longer ovulating or the menstrual cycle starts to be disrupted and eventually leads to anovulation and loss of the menstrual cycle. It’s often due to not consuming enough energy to offset how much energy you’re putting out — either undereating, over-exercising, usually a combination, and sometimes stress or a combination of all three. And the conventional approach to HA is just calories — just get enough energy, that’s the end-all be-all. There’s also some stuff floating around suggesting a minimum carbohydrate level. But as a whole, when you look at the studies where they’ve actually assessed dietary intake — often these women have an eating disorder or some form of disordered eating. And many times they’re specifically limiting their fat and their animal product consumption as much as possible. So carbohydrates — even though they’re way undereating on calories — carbohydrates actually make up the majority of their diet because protein is bad and fat is bad because fat has calories or whatever the rationale is. And so they’re eating mostly carbs — 60, 70% carbs — and very little of everything else. And I found this interesting because in practice I find that increasing protein intake and fat intake, particularly both from animal foods, does wonders for restoring the menstrual cycle or improving ovulatory function, improving blood sugar and insulin levels, getting hunger and fullness cues back in a healthy place. And I found it interesting that for a condition we usually just think is lack of energy as a whole, I actually think it’s often lack of energy from all macros. I’m not pro-limiting any of them for this particular cohort. But I think specifically focusing on protein and fat and making them feel okay with eating meat can go a really long way to restoring the cycle.

Lisa: And what’s interesting about that example is that it confirms what I see when I’m working with clients in this area — undereating protein, eliminating fat for women in that category. So yeah. I mean, what was the favorite part of the book?

Lily: I definitely — we worked so collaboratively on the HA chapter and the PCOS chapter. Those were primarily my responsibility and obviously you nailed the nutrition section on PCOS. And we worked so collaboratively on the HA section. I feel that’s one of my favorite chapters. Those chapters really — because we’re both clinicians, we can get in the mindspace of that type of client and write to them. Originally I think in one of our outlines we had HA and PCOS combined in one chapter and then we’re like, we’re writing to two different women. We really need to have these chapters separate. I’m glad we did. I think we really get into the psychology of it. The HA chapter has a lot of what I would say like handholding, because it’s so challenging to really nail down the importance of consuming enough energy and being honest with yourself about whether you’re really adequately fueling, and the exercise component — are you actually a compulsive exerciser? There’s a lot of people where they just go way way over the top with exercise. Those chapters are awesome.

For me, I really took the lead on the first big chunk of the book — heavily all the nutrition stuff — chapters two through five. And I love all those chapters. But I would say the vegetarian chapter — when we were bookwriting buddies and I was writing Real Food for Pregnancy, I find that with each book I get more and more detailed and more and more willing to say what I actually mean clearly, not beat around the bush. Some of this also just comes with age. You just care less about being cancelled. If you’re going to say something of value you’re going to upset people. So in Real Food for Pregnancy I have a chapter on foods to emphasize and I have an addendum on the challenges of a vegetarian diet in pregnancy. But it’s stuck at the end of a chapter. It’s wildly in opposition to the pregnancy guidelines, which say a vegetarian or vegan diet is fine at any life stage with proper planning and supplementation. I have a different opinion. And so in this book it was like, okay, this needs to be its own chapter. And it does need to be said on the vegetarian component. Since the release of Real Food for Pregnancy, literally every single week I get feedback — whether it’s direct messages on social media or emails — with just absolutely astounding firsthand stories of how this person was a long-term vegetarian or vegan and they had no idea of all these potential deficiencies or all these things that were off. And it took them a while but they decided to reintroduce things. And then — wow, they had this amazing result. Maybe they struggled to get pregnant a second time, their cycle was a hot mess postpartum, or maybe recurrent miscarriages, or whatever it is. And how things improved so much when they included animal foods. Once I really started to dive in on that topic, that chapter is far more than just micronutrients. I’m really getting more specific on the macronutrient ratios and how those are off. You get the macronutrient ratios off and it’s associated with ovulatory problems. Too many carbs, too little protein, and too much omega-6 fatty acids — you’re setting yourself up for ovulatory problems. And that scenario is almost impossible to avoid on a vegetarian diet. Learning about all these individual amino acids and how they affect ovulation, early pregnancy, embryonic development — I was like, that needs to be said. If there is ever a resource that is giving you a non-emotional, purely from a data standpoint view of where there are holes in that sort of dietary approach and how it specifically impacts fertility — this is definitely the one.

I know some people had written in like, aren’t you worried about the flak you’ll get? I’m like, I actually receive very little flak on my writing about vegetarian diets because I think I do it from a place of writing specifically from the data points. And some people — I’m not here to really change minds. I’m here to present data. And so there will always be people who choose to eat whatever way they’re going to eat. We’re actually not even entirely anti those diets in that section. We don’t tell everybody to stop being vegetarian. We make them aware of some of the areas that you may need to supplement and improve dietary balance and refine your diet. And then how to do so — the specifics on how to reintroduce animal foods if you want to. I think that is something I’ve not seen in any other resource. And that is a question I get from people — I read Real Food for Pregnancy, I want to include animal foods again, how do I do it? Where do I start? So we have a whole section that walks you through all the different ways you can think about it and do it. Because there really is no right or wrong way. But nobody has written it out with a step-by-step of what considerations are important to you. That’s my very long answer to why that chapter was such a labor of love. It’s going to get a ton of criticism. I’m okay with that. I expect it. But I think it’s going to be a really valuable resource for the people who need it.

Lisa: And what I love about it is that from clinical observations I’ve observed — and it’s controversial, if I’m going to get bad feedback on a podcast it’s always going to be on a podcast that addresses this question — what I’ve seen is that when I have a client who is not consuming any animal products or very little, it’s very difficult to meet that macro ratio, to get enough protein and fat. And that plays out hormonally. So it’s very difficult to have optimal hormone balance when you’re consuming that way. And it’s not my opinion — we’re looking at the cycle and we’re seeing those cycle issues. And I’ve spoken to many clinicians in different areas who’ve seen a similar kind of thing. You have a client with these goals to achieve balanced hormones. But they have a limit in terms of what they can consume — especially if they’re vegan. And even if they do to the best of their ability within their dietary constraints plus adding in a bunch of supplements, for many clients there’s kind of a limit to the success they’ll achieve in terms of balanced hormones. And then what I’ve observed is that for those women who then choose to incorporate some animal foods, often that helps them bridge that gap and actually get the results they’re looking for. Whereas the ones who are not able to do that are often left in a bit of a stalemate. I feel like your chapter going into a lot of those holes that have not really been explored to that degree in other resources helps provide that explanation as to why. What does the data have to say? What is the research? What is the reason? It’s not just that the vegetarian or vegan diet is low in B12. We’re past that. It’s more than that.

Lily: And that’s my frustration with most of the conventional resources on vegetarian or vegan diets. They come from the assumption that our guidelines as a whole are accurate. So when we’re talking about it containing enough protein, they’re just talking about 0.8 grams per kilogram per day. The RDA for women is set at 45 grams of protein per day. But if this is our benchmark for protein adequacy — which we go into in the book in detail — that’s not enough for like anybody. And on top of that, research that was new to me that was surprising — I didn’t know this about our dietary guidelines — our protein recommendations, the RDA, assumes for vegetarians that at least half of their protein is coming in from animal sources, meaning eggs or dairy products. So they don’t set a separate RDA for vegetarians under the assumption that half of their protein is high quality, has all the amino acids in balance, because they’re getting it from eggs and dairy. And there’s actually new data suggesting that vegetarians should probably be consuming at least 20% more than omnivores due to lower protein quality, imbalance of amino acids, and inability to digest those proteins as bioavailably. And that was new data for me. Then you combine that with the data we already have showing the RDA for protein is set too low — arguably probably about 50% too low. And where are we at? Do vegetarians need like 70% more protein? How are you going to pull that off? You can’t pull that off with whole foods from vegan sources because all of your plant sources of protein come with a lot of carbohydrates. So you’d have to consume mass calories and mass carbohydrates to make your protein levels go up — unless you’re doing protein supplements. And then what do we do about the amino acid balance? Because now we have all this data that these so-called non-essential amino acids are actually required for fertility, for ovulatory function, for sperm quality, for egg quality. It opens up a whole lot of questions that nobody has ever explored before. This is not discussed in any other resource. It’s always glossed over because the assumption is that the RDA is accurate and that non-essential amino acids are truly non-essential. It’s not true. And so we’re left with just a hot mess. I hope this chapter really does end up clearing up some confusion. It was fascinating to research and write.

Lisa: And one last thing to say about the chapter — like you said at the outset, we’re not here to tell somebody do this or do that, just to present the data. And in that vein, you present the path to optimizing. So for anybody for whom this diet is non-negotiable, you present the tools to optimize that. If animal protein is kind of off the table — well, we’re showing you the data but we’re also showing you the best way to incorporate these principles. And I think the main takeaway is that we wouldn’t recommend a vegan diet — it’s just not something that is optimal for fertility. But if you incorporate many of our suggestions to then optimize a vegetarian diet, you’ll be a lot more informed about how to do that in the best possible way. And then you will have to face some of those questions about those holes and gaps. But why should this information not be provided? It’s the same kind of question — sometimes they’ll say, it’s so negative, she’s talking about all this stuff to dissuade people. Come on, like no I’m not. But if you’re taking something or doing something, shouldn’t you be privy to what it really does to the body? Shouldn’t we be allowed to have the information and then make that informed choice?

Lily: And likewise your sections on hormonal birth control — and the nutrients that can be depleted from it, and how there’s delay in the return of your cycle and the return of normal ovulation and the return of egg quality parameters and ovarian reserve parameters. That is something that’s not common knowledge. And sometimes this information is uncomfortable. But I think we were really careful with our language around things where even if we’re stating uncomfortable facts we’re trying to do it from a place of empowerment. I think that comes across based on all the advanced reviews we’ve had, which have been overwhelmingly positive. We really did make an effort. But there will inevitably be people triggered — particularly because fertility is such a sensitive topic. And yet we really made an effort to be as informative and non-triggering as possible while still stating the facts.

Lisa: Well, anyone who’s listening can tell we labored over this. It’s definitely a labor of love. Our contribution to the fertility discussion. We’re both very pleased with how it came out. And we just can’t wait to see what impact it has. We feel — and I’m speaking for us here, so jump in — we feel that this is necessary. Like this is where we’re at. And we didn’t talk a lot about how this infertility issue is growing, how it’s becoming more of a problem, how more and more people are struggling to conceive. And still to this day — I first entered this field of fertility awareness over 20 years ago. And yes, the world is different now and a lot more women know about fertility awareness and cycle charting. But the average woman still is the same as she was 20 years ago. We’ve made a lot of progress in many ways, but it’s definitely not mainstream. So with that said, we should probably wrap up. We have to add one more thing though — so many of the existing resources on fertility don’t talk about the men at all.

Lily: Yes, that too. That’s been a huge, huge piece of the feedback that we’ve had from our advanced reviewers. You know, if I’m correct, I think it’s 50% of infertility cases that couples face have male factor involvement. And then you have all these resources that are only talking about women, egg quality, and menstrual cycle. Or glossing over the men. Exactly, totally glossing over it. So then it’s like all the women’s problem. Like that’s messed up. You really have to advocate for yourself in healthcare settings to even get sperm quality analysis. Like it’s ridiculous. I’ve had clients where the clinicians just tell them no.

Lisa: So to share — because this is huge. I first discovered fertility awareness when I was still a teenager. And so I was very much avoiding pregnancy for my entire 20s until I was married and my husband and I decided to start for a baby. I was very much using this method to avoid pregnancy — avoiding unprotected sex in that window, like the plague. And from my personal experience, when my husband and I tried for our first baby, I got pregnant on my fourth cycle. So I didn’t get to the point that I was actually nervous, but I remember being like fascinated. Like, this is so weird — we’re having sex in the window and it didn’t happen the first time. And I wasn’t nervous, but I just remember being like, wow, this is so weird. And then I conceived and miscarried, and then I conceived in the following cycle, and that was our first baby. With my second and then my baby who’s 18 months old — literally one cycle. And I’m not saying this to brag. I’m saying this to share that I have lived in this world where if I were to have unprotected sex in that window, it results in a baby. So you can imagine my surprise when I start working with clients and I’m seeing it — we’re looking at the chart, they’re timing sex correctly, they’re having sex at the correct time cycle after cycle after cycle, and it’s not happening. And you’re confirming ovulation is actually happening. You can see it in their cycle parameters. I can see when they have their cervical mucus. I can see when the sex is happening because one of the things I teach my practitioners and do with clients is confirming — are you noting all of the acts of intercourse on the chart? It’s part of the whole way to examine that we’re following the method correctly. So obviously when you’re seeing that, especially coming from my own experience of using it primarily for birth control initially, you have to start asking — why is this not happening? And so it quickly came to my attention that we need to be looking at the men. And from a statistical standpoint, when we’re looking at couples who have been trying to conceive for a year or more without success who’ve been timing sex relatively correctly — from a statistical standpoint, the partner’s sperm is not optimal. It may meet the World Health Organization basic parameters, but statistically he’s far more likely to miss those optimal values. And I think this is a huge part of that fertility conversation that is not coming to light. All these men are being told that they’re fine because they meet the WHO sperm parameters. But that is not optimal for natural conception. And none of our audience listeners are looking at just fine for their family building goals. They want it to be optimal.

Lily: And there’s just why the sperm quality chapter is so awesome — there are tables in it showing where the World Health Organization sperm parameters are, and how they’re just so low. And then there’s also a table showing from studies looking at natural conception, the sperm quality parameters that are actually optimal. So if you are able to convince your provider to do an analysis, you can see what the values are and actually compare them. You always want to ask for your full lab test results — and for this as well. Then you have a game plan. You can be like, okay, well this is not optimal. Okay, these are all the nutrients that are going to optimize semen quality. And ironically it’s a lot of the same stuff that optimizes egg quality and optimizes ovulation. You don’t have to do two separate plans for different partners. You might have a handful of things you choose to selectively supplement or focus on, but there’s really a lot of overlap. So it just puts you more in the driver’s seat of this whole conversation instead of feeling like totally stuck completely out of luck or like your only option is to do ridiculously expensive fertility treatments. Even if those end up being needed, because those are sometimes needed, you can improve your chances that they’ll be successful so you don’t have to do as many cycles to actually achieve pregnancy. And sperm quality can impact the outcome of your pregnancy as well, because sperm DNA — the male DNA is more expressed in placental tissue than maternal DNA because it’s formed from the embryonic tissue. And there’s actually data suggesting that certain pregnancy complications like preeclampsia actually have a male factor component. So if we can optimize the man, we might — beyond just the conversation of let’s get you pregnant as soon as possible — let’s get you pregnant with a healthy, viable pregnancy with fewer complications sooner. We have to take it beyond build your nutrient stores ahead of time. It’s like the full life cycle.

Lisa: Yeah, and it’s been really interesting to see how many of our advanced readers have commented on the sperm. I was asking questions like, did anything surprise you? And it was like, I had no idea of the impact of the male factor. And this is the whole point. There’s no man alive that’s so healthy that he can’t benefit from improving his diet or male-targeted supplementation. Men, you’ve been put on notice. You’re on blast.

All right, Lily — why don’t you share where the listeners can go to grab the book and to get the download we were talking about with the citations, and of course for those who would love to read the first chapter for free?

Lily: Yeah, so realfoodforfertility.com — very simple. It’s just the title of the book. Four is written out, F-O-R, not the number four. Check it out. That has all the links to where to buy the book. Paperback and Kindle or ebook are available. There’s a little tab there to download the reference list. So download that reference list PDF. If you’re not quite sure you want to buy yet or want a preview of the book before you start reading, download the first chapter for free. That actually has the foreword, introduction, and the first chapter. And there are some other links in the book that’ll take you back to the website for a few other resources. But definitely go there. That’s the best way to find the book — or just search Amazon, Real Food for Fertility. It should show up. And we hope that it’s received well and ranks well. If you love it, the number one way to help a book succeed and to help other people find it is to leave a review — ideally a verified review, which means you’ve purchased a copy. That tells the Amazon algorithm — and 95% of books are sold on Amazon. That is really the most helpful place to buy a book and leave a review. That’s where most people are searching for and buying books. So if you love it, please leave a review. Any review really helps the book succeed and reach more people. That would be our biggest ask if you decide to purchase and like it.

Lisa: Yeah, for sure. And if you think about how you buy anything — what do we do? We go to the reviews first and we see what other people thought about it. So definitely I second that.

Lily, I — well, we’ve shared how good friends we are and how we’ve been talking weekly for many years. So we could do like an afternoon with Lisa and Lily. Yes, I know — seriously, we totally could. And people would probably love that. But I hope that the listeners have enjoyed this. It was so fun just to chat about it. It was actually really nice. We’re at such a good place in our publishing calendar to be able to go back and talk about some of our research finds and kind of revisit when we first had this concept. And it really takes a lot of dedication and effort and work to get it out. And I mean, I’m proud of us.

Lily: No, I’m proud of us too. I had multiple moves. You had a baby. We both launched practitioner training programs in the midst of this. We’ve had a lot going on, and yet this book has always been really taking priority. And even if it sat aside on the back burner while it was with an editor or something, it still has always taken priority. And I’m proud of us for finishing it because it is really hard to bring projects this big to completion. I just really hope it helps as many people as possible. It’s like a $10,000 course in a book, really, the amount of information. And when I got the proof copy and you said 30% bigger than Real Food for Pregnancy — like when you actually see it, it’s a lot. But like we said, everything that’s in there has been vetted a hundred times. So there’s nothing extraneous in there. We really were cutthroat on the editing.

Lisa: All right, well Lily, thank you so much for being here. This has been so much fun. I’m really excited to share this episode. And you know — happy launch day! And we didn’t mention that we launched on Valentine’s Day. So happy, happy love day to everybody. We thought that was your idea as well, which I thought was brilliant. It makes perfect sense. And what a lovely way to complete this project — to release it on love day.

Lily: Happy Valentine’s Day and happy reading.

Lisa: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/508. I hope that you enjoyed today’s episode with Lily. I had a great time recording it and it was really nice to be able to chat and to catch up and also to share some of the behind the scenes with you. So I know some of you were really curious as to how this came about and our research process and how we were able to choose who’s going to write which sections and all the things. So thank you all for the great questions for those of you who had responded on social media. It really helped us to kind of not to say structure our conversation, but it gave us some great questions to ask. So stay tuned for our next episode on Friday. We’re going to go into some more details about the content itself of the book. We’re going to talk a little bit more about the nutrition aspect of the book and how it relates to fertility and why we chose to take the approach that we did. So of course I hope that you enjoy the rest of your week, weekend, whenever you’re tuning into the show, and until next time be well and happy charting.