🎧 Episode 10: The Fertility Diet That Actually Works: What to Eat to Get Pregnant with Judy Simon, RDN
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In this episode of The WOVA Circle Fertility Podcast, I sit down with Judy Simon, MS, RDN, CD, CHES, a registered dietitian nutritionist who specializes in reproductive health, Founder of Mind Body Nutrition, and Clinical Instructor at the University of Washington. We dive into why nutrition is THE foundation for conception and pregnancy, and how simple, practical dietary changes can dramatically improve fertility outcomes without requiring a complete lifestyle overhaul.
This transformative conversation explores Judy's 15 years of teaching Food for Fertility classes and her newly published book "Getting to Baby" We discuss why fertility challenges are often rooted in what we're NOT eating rather than what we need to eliminate, how plant-forward eating improves egg quality and sperm health, why gut health is critical for hormonal balance, and how nutrition can help women with PCOS ovulate naturally. Judy breaks down the science in accessible terms and provides actionable strategies to nourish your body for baby while living in the real world.
What You'll Learn in This Episode
The strongest research connecting nutrition and fertility outcomes
How blood sugar, inflammation, and gut health impact reproductive health
Why male fertility matters just as much as female fertility
The truth about soy, supplements, and common fertility nutrition myths
Why sustainable habits matter more than restrictive diets
Practical nutrition and lifestyle shifts that can support conception
How nutrition may influence pregnancy outcomes, including gestational diabetes and preeclampsia
The simple daily changes that can make the biggest difference for fertility health
⏱ Listen time: 70 minutes
🎧 Format: Video & Audio
📍 Best for: Individuals and couples considering or undergoing IVF, those wanting to better understand fertility treatment, and anyone looking for a more informed, balanced approach to reproductive health
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👉Learn More About Gabie’s Story
Podcast Transcript
Introduction
Gabie: Welcome to The WOVA Circle: real talk on fertility, wellness, and trying to conceive. I'm Gabie Peytchev, founder of WOVA Health and fertility educator. This podcast is your community space for navigating the path to parenthood with evidence-based insights, authentic conversations, and genuine support. I'm dedicated to being here with you through every part of your journey.
Welcome, everyone. Today I'm joined by Judy Simon. She is a registered dietitian nutritionist who specializes in reproductive health. She's the founder of Mind Body Nutrition and a clinical instructor and staff dietitian at the University of Washington. Her expertise includes PCOS (polycystic ovary syndrome), fertility, eating disorders, weight-inclusive care, culinary medicine, and reproductive health. Judy has held leadership roles in the American Society of Reproductive Medicine's Nutrition Special Interest Group and is a Fellow of the Academy of Nutrition and Dietetics. Did I miss anything important from the introduction?
Judy: No, I think that's great. Thank you.
Gabie: I am so honored that you're my guest today. Your book, Getting to Baby, is packed with so much good information — it's actionable, easy to understand, and easy to digest. What I find helpful is that when you know whyyou need to eat more leafy greens, for example, you're more willing to take action and make a shift. You also share a lot of recipes for people who don't know how to cook or how to incorporate new ingredients. I just loved it.
Judy: That means a lot to me, because you've been on your fertility journey and now you're educating, coaching, and helping folks on theirs. Of all the podcasts I've done — and I've done dozens since the book came out — you've asked the most extensive questions. You're really diving deep, and we need people like you advocating for those going through fertility challenges.
Gabie: Thank you, Judy. My interest in whole-body health goes back 12 years, even before I started dealing with infertility, so I love digging deeper and learning from experts like you.
Food-First Fertility: The Foundation
Gabie: Let's start here — what does food-first fertility mean in one sentence? And what is the simplest thing someone can start today?
Judy: I've practiced my one-sentence definition because I can go on and on. Food and nutrition are the foundation of health. They can't be skipped or replaced for conception and pregnancy. It's foundational.
For your follow-up — what people need to include — and this is for both men and women, people of all genders — they really need to be more plant-forward. That's scary for people because they're getting mixed messages. They think, "Well, I don't want to be a vegetarian," or "I don't cook." It's actually really easy, and we'll get into examples today.
The "Add-In" Approach: Behavioral Change Over Restriction
Gabie: Do you feel like you're getting more resistance from women or men when it comes to cutting down red meat?
Judy: A little of both. I don't get that much resistance because of how we talk about it in the book — we present what the science says, and we focus on what you can add in.
I worked with someone yesterday who was eating steak at 10 in the morning — a pretty heavy red meat eater. Instead of judging her, I asked, "Are there any types of fish you enjoy?" She lit up and said, "I love salmon." So we jumped into meal planning. Instead of saying "Don't eat so much red meat," we talked about preparing salmon one night for dinner, with enough leftover for a fish taco the next day or salmon in your salad. That's two meals of fish. If we add in more plant-based meals — making chili with beans and vegetables, for instance — all of a sudden the red meat is shrinking without me ever telling her to cut it out.
The exception would be processed meats. There's a big difference if someone tells me their husband hunts and they have fresh venison — that's free-range, grass-fed red meat with iron and less saturated fat. So you have to dive a little deeper, but when we work on the add-ins, the less-helpful foods get pushed out. Instead of shaking your head and saying "that's bad," talk about what can you add in.
Gabie: I love this approach. One of the success stories in the book mentions exactly this — you don't tell people everything they need to stop eating. You tell them what to start incorporating. It's a behavioral-change approach.
Judy: When I went through my training a long time ago, health sciences were very black and white. We were judgmental and very behavioral, and we found out it wasn't effective at all — you weren't changing anyone's behavior. When you approach it from social learning theory and motivational interviewing, you find out what's motivating people. Why should they even want to make a change?
I'm hoping people read our book and think, "I want to get pregnant — does nutrition have a role?"
Why the Book: 15 Years of Food for Fertility Classes
Judy: It's important for listeners to know we didn't just dream up this book. This was 15 years of teaching Food for Fertility classes. Those stories are from women who went through the classes and were so successful that we thought, instead of helping 12 people at a time, let's reach more people.
We published early data in the American Society of Reproductive Medicine showing that in just six weeks we could see biomarkers improve — blood sugars, lipid levels. Doctors started seeing women who no longer had to go through IVF because they were ovulating and getting pregnant on their own. We had many of those stories.
My goal is that every library has a copy of the book. It's a resource available at no cost to anyone trying to get pregnant, because fertility can be so expensive. People have a lot of barriers, and if we can help build more families, that's the goal.
The Real Cost of Fertility — And Why Nutrition Matters First
Gabie: That's really kind of you. It can be so expensive. I was lucky — I worked at a company with fertility coverage. We were dealing with male factor infertility, and as I approached 35 I got nervous. We spent $100,000 on three IUIs and three IVFs, even with coverage. I know people who've gone through 5, 6, 9, 10 cycles. IVF is amazing, but you can't just keep going without looking at what's underneath. Like you said, nutrition is number one — you can't just take supplements.
Judy: I'm shocked sometimes when I add up how much people spend on supplements they read about somewhere. They put all that energy into pills, then when it comes to food they're laissez-faire — "Oh, we eat out, we grab this." I tell them, you could get a lot more benefit from optimizing your health with lifestyle and nutrition, because the two go hand in hand.
I've had success with people who say they don't cook — they eat out or pick things up from the high-end grocery store on the way home. I work with them: let's build those meals however you're making them. One particular couple got pregnant, had a healthy pregnancy, and came back later wanting to learn to cook for their child. They had to be ready. They thanked me for not judging them. Getting to Baby gets you the baby, hopefully — and then you know how to nourish that baby. Your child watches what you're eating; that's how they learn how to eat.
Gabie: It's true — you don't have to suddenly overhaul your lifestyle. Even a 20 to 30% shift is a huge improvement. Start with small steps.
Don't Forget the Men: Nuts, Seeds, and Sperm Quality
Judy: When you talk about small steps — I want to talk about men. You know that 30 to 40% of the time, the fertility issue is male factor. A lot of women come to me saying, "I'm prepping for IVF." I ask if they know the cause. "Oh yeah, male factor." But where's that partner? His health matters too.
When I can't get the guy to come in, I'll work through his partner. If he can just do a few things — when it comes to food, do you know my number one? Nuts. Nuts and seeds. A handful every day. They're loaded with trace minerals like selenium and magnesium, which really help with sperm quality. Antioxidants, omega-3s. If I can push further, I want him eating fish and seafood, and making sure he has enough vitamin E. Men often say, "Oh, I'm taking a male fertility supplement." I ask, "Okay, but what are you eating?"
We have very few randomized controlled trials in this space, but there was one called the FERTINUTS trial, where for 14 weeks men ate nuts daily. After 14 weeks, all their sperm parameters improved. They didn't take it to live birth, but the sperm were better — and the men weren't told to change anything else in their diet. So we have enough science to say there's a reason.
Most fertility nutrition research is prospective. The original fertility diet study followed the Nurses' Health Study cohort that wanted to conceive — researchers had great records of what people were eating, lifestyle habits, who got pregnant. Nobody told them what to do, so that's one way to see relationships. It's really hard to do a true randomized controlled trial — telling couples "you eat this way for a year, you eat that way" — but when findings replicate across many studies, that gives us a better understanding of the mechanisms. Nutrition is hard to study, and researchers have found it's easier to look at dietary patterns than single nutrients. That's much easier to translate into what's on your plate.
The Strongest Research: The Fertility Diet and the EARTH Study
Gabie: What is the strongest research linking diet to fertility outcomes?
Judy: I'd say it's a tie between two studies. The first is the fertility diet, the Harvard studies from the early 2000s following that nurses' cohort. That was groundbreaking — it was the first time researchers could really look at what someone was eating and their time to conception.
The second is the EARTH study, with results coming out around 2018 — and they're still mining that data. They followed couples going through IVF. Before treatment, they asked about diet, supplements, environmental exposures. The question was: why isn't IVF 100%? If you could take a great egg and perfect sperm, why are clinic success rates 60 to 65% and not higher? What role does diet and exercise play?
What they found, specifically — the women in the top quartile for take-home baby success (not clinical pregnancy, not blastocyst count — take-home baby) ate food from all the food groups. They ate grains, they ate fruit. They had fish two to three times a week. They included soy, which some people were afraid of in the past — and it actually correlated with lower amounts of endocrine disruptors in their system. If they were depleted in vitamin D or B12, they supplemented. The researchers called it the pro-fertility diet.
Why "Plant-Forward" Beats "Mediterranean"
Judy: Terminology gets confusing because some people call it the Mediterranean diet. I steer clear of that label because most of my patients aren't from the Mediterranean. They might be South Asian, Mexican, Chinese — all different cultures. If they hear "Mediterranean diet," they think, "Well, I'm eating dal and chickpeas — is that the same?"
We need to take away the cultural bias and just say: a more plant-forward way of eating that's anti-inflammatory and low glycemic. For my vegan patients, I'll talk about what they can get from diet and what to supplement. It's the inclusion of plants and fiber that matters.
As we learn more about reproductive health, we know inflammation is a barrier. Endometriosis and PCOS are highly inflammatory states, and they're some of the most common reasons people end up at a fertility clinic.
Slowing Egg Aging: Nutrition Before IVF
Judy: There's also a lot of emphasis now on women conceiving older. When you look at the data, the age curve is just moving over — and yes, men too.
Gabie: And men.
Judy: It makes a big difference in women. It's not a cliff at 35 — fertility just continues to diminish. So we're trying to do everything we can to slow egg aging, be anti-inflammatory, protect the mitochondria — the powerhouse of the cell — with antioxidants.
I see many women over 40 using IVF. They have diminished ovarian reserve appropriate for their age. Sometimes they have endometriosis or PCOS too, but a lot of it is just where they started on the journey. Quite often they've had a failed cycle — no blame, nothing is 100% — but luckily they have more embryos, and the doctors learn what to adjust. Then they come to me: "How long do I need for nutrition?" Ideally a minimum of six weeks, but the three-month window is even better, because new sperm develops over that time and you have time to positively impact the follicular fluid for the egg — more antioxidants, less inflammation.
The fertility clinic sends me anyone who barely has pre-diabetes because they want to reduce that inflammation. We know we can get better outcomes if glucose levels are regulated. We want to manage chronic disease and do everything we can. I see women in their forties go back for a second or third IVF and have successful pregnancies. I have a few women pregnant right now. One was getting ready for her next IVF cycle and spontaneously conceived this summer. She said, "I wish I'd done nutrition before the first one." We can't promise outcomes, but there's no downside to a healthier life.
I remind people: you want to be a healthy parent. Not just pregnant — healthy.
Preconception Planning and Pregnancy Outcomes
Judy: Another motivator we mention in the book: what you're eating at conception can help reduce the risk of adverse pregnancy outcomes — preeclampsia, preterm labor, gestational diabetes. Women ask what they can do. The answer: 150 minutes of exercise a week — even just walking — improves insulin resistance. Eat well: fruits, vegetables, whole grains.
We know from NHANES data that pregnant women in general are deficient across the board — low in fruit, vegetables, whole grains, fish, eggs. No supplement can compensate for that. If you come in not eating well and then you're nauseous for eight weeks, baby will take what baby needs — but it's not ideal for either of you.
Getting to Baby isn't only for fertility problems — it's to optimize fertility. More people are planning for preconception now. They're seeing friends struggle and thinking, "Let's prepare a little more rather than just stop birth control."
Gabie: There's a bit more awareness now, though most people who reach out have been struggling for a long time. I wish more people would start preparing when they decide they want to grow their family, regardless of whether they expect trouble conceiving.
Judy: People reach out to me saying, "I'm doing my transfer in two weeks." I say, "Okay, let's make the next two weeks amazing." When I started in this field 20 years ago, we had almost no science specifically through an infertility lens. I felt like one of the lone people out there — the only dietitian sitting in ASRM meetings. It's come a long way, but it has further to go.
What Plant-Forward Actually Means
Gabie: Let's specify plant-forward. What does it mean in short?
Judy: When you're choosing meals and snacks, you're thinking fruits, vegetables, whole grains, legumes, lentils. There's a lot of fear about carbs — that could be a whole podcast. Carbohydrates are your energy foods, and the ones you select can be amazing. Don't be afraid of them. Beans have protein and fiber.
To be specific: unless you have GI issues — in which case work with someone individually — aim for two or three fruits a day and vegetables with every meal and most snacks. People ask, "How do you eat five or six vegetables a day?" Make a stew or soup with lots of vegetables. Don't think solo vegetables — think green beans, mushrooms, and peppers together. How many can you add in?
Use more whole grains. If you can't eat gluten, there are plenty of options — quinoa and others. Try to include fish two to three times a week. I like women to have three to seven eggs a week if they eat eggs, because the yolk is the best source of choline.
I'm not knocking protein, but right now people are obsessed with it. It's not that hard to get enough protein, and you can do it plant-forward with planning. You don't have to have dairy. We have some data — especially for women with PCOS — that one full-fat dairy a day can be helpful with ovulation. But not everyone tolerates it. There are great plant milks: soy milk, pea protein, often fortified with calcium. Healthy proteins also include chicken, lean pork. Red meat is okay — it has nutrients — but fatty red meats have more saturated fat and have been correlated with poorer fertility outcomes, so use those more sparingly and pay attention to quality and quantity.
Why these foods? They're loaded with antioxidants, lower glycemic, higher in fiber, and anti-inflammatory. They provide what you need for healthy eggs and a healthy uterine lining — and they prevent chronic disease.
One quick clarification: people get the idea that we want everything in our body to be anti-inflammatory. Actually, there are mechanisms in the body where we do want some inflammation — it's about balance. If someone runs a marathon, that causes oxidative stress, but if they're eating well, they balance it out and build muscle and endurance. Not every action in your body needs to be anti-inflammatory — we just want good balance.
Gabie: To summarize: plant-forward doesn't mean only plants. You can still eat red meat, just less. Focus on vegetables with most meals, plus fruits, whole grains, and nuts. And focus on variety — if you're eating the rainbow, you don't have to think about what each individual food is giving you. So much easier.
The Gut-Fertility Connection: PCOS and Endometriosis
Judy: Exactly. The most exciting research that has come out is on the gut microbiome — I didn't know about this 20 years ago. You asked a great question earlier: is there a difference in the gut biome of women with PCOS or endometriosis? The answer is yes.
There was just an article this past month in a major fertility journal looking at PCOS, gut microbiome, and mood — all the things related to our gut, our endocrine and immune systems. When I have patients who are macro counters, I tell them: try counting fiber. See if you can get 25 to 35 grams a day. Then they do it and say, "Oh my gosh, I'm pooping so well, my gut feels great." Some even lose weight because they're getting more plant foods.
Researchers have found that women with PCOS have less diversity in their gut microbiome and a depletion of certain important bacteria. They think some of those missing bacteria are drivers of inflammation. Same with endometriosis.
Why do women do so well when they get more fiber? They improve the integrity of the gut lining. Some people use the term leaky gut — it's quasi-scientific, but the idea is real. A healthy gut lining produces enzymes that help reduce excess estrogen, which we find in women with PCOS and endometriosis. There are also mechanisms that reduce excess androgens. So much endocrinology happens in the gut — people have no idea.
I used to see a lot of women in larger bodies with PCOS on very low-carb diets. They were eating almost no carbs and very little fiber — constipated, not feeling great, often not losing weight either. But that's what they thought they had to do. I'd tell them whole grains and beans are actually anti-inflammatory and they add fiber. As they built trust with me and slowly added them in, we saw improvements in blood sugar, gut function, and ovulation. All these body systems work synergistically, but we have to give them the nutrition they need.
Why Fiber Matters
Gabie: Why is fiber so important? You talk in the book about how fiber feeds the gut bacteria.
Judy: Fiber is the real prebiotic — the food for the good bacteria. Fiber is indigestible plant material, so by the time it gets to your large intestine, it's broken down and produces butyrate and other short-chain fatty acids that are really healthy for us.
Fiber also lowers blood sugar. If I have a patient who eats white rice three times a day — that's their culture — I'm not going to tell them to switch to lentils. But I'll say, "What if you eat twice as much vegetables as rice on that plate? Really up the fiber." Then they tell me their blood sugars are so much better. Fiber slows down the absorption of carbohydrates. If you pair white beans or hummus with white rice or plain white pasta, the absorption is much slower.
Fiber-rich foods also help the body release GLP-1 naturally. We hear about Ozempic and Wegovy — those are synthetic GLP-1 agonists, but the hormone happens naturally in your body. When you eat a lot of white beans, you feel full sooner, your brain registers satisfaction, and you have a slower blood sugar rise. That's especially helpful for people with insulin resistance — and many don't even know they have it. About 80% of women with PCOS have some degree of insulin resistance.
Beyond Weight: Health at Every Size in Fertility Care
Judy: It doesn't matter if a woman is lean, heavy, or in between — we don't know why lean women with PCOS store more visceral fat even when they're athletic. These same principles help people no matter their size.
Fertility is still hung up on losing weight. You'll read fertility articles saying weight is a risk factor, and I really disagree — because being in a smaller body doesn't mean you're eating healthy. Many women in larger bodies have perfect blood sugars and all their biomarkers look the same. That's especially true if they're not having ovulatory disorders.
At the University of Washington, we published a study looking at women with BMI from 38 to 63 — much larger bodies. Because we have a weight-inclusive clinic, we evaluate each person on their health and whether they're a good candidate for IVF. We compared those women to women with BMI under 30, considered a "healthier weight." There was no difference in outcomes — not even in the children at one year. They're seeing this in major medical centers that have the team — anesthesiologists, dietitians, the full support — to help everyone be healthy no matter their size.
Telling someone to take a GLP-1 and wait two years, or to have bariatric surgery, is pretty extreme. Almost half the women whose stories we share in the book are in larger bodies. They were initially sent to me to "focus on losing weight," and I'm here to say we focus on health. A lot of them do lose weight, but that's not a goal — and studies have shown weight loss before IVF doesn't make a difference for IVF outcomes. Why lose three months trying to lose weight? Let's focus on health for everybody.
Gabie: I can't agree more. Don't focus on weight or counting calories — focus on what's on your plate. Quality and quantity matter, and whole foods beat processed foods.
Whole Foods, Cravings, and Eating Competence
Judy: I help women who say, "Well, I love to snack on X, Y, or Z," and maybe it is ultra-processed. Half the time, they're going too long without eating, and whatever they grab is what's easy. I ask, "What are you looking for? Salty and crunchy?" Let's try a variety. I don't knock out their favorite food — we talk about popcorn, roasted lentils, beans, wasabi peas, lots of nice crunchy things. What are you looking for in that crunch?
Almost always, when they start eating more regularly — which we really talk about in the book through eating competence, feeding yourself faithfully, deciding how hungry you are at each meal — they're less likely to binge or to grab something at a gas station because they're starving. It's being compassionate to yourself.
Gabie: I notice the same thing. If you experiment with yourself and take notes, you can really see the difference within a single day. Skip lunch or eat a small, non-nutritious lunch, and yes — you're going to crave a sweet or salty snack.
Judy: And that's okay. But learning what you're really looking for and gravitating toward minimally processed foods makes a real difference. Better-quality meal delivery services or meal kits can be a gateway — they come with recipes, it's culinary medicine, teaching people how to cook. Then knowing your backup restaurants for rough days. Having that plan feels good.
Fertility Nutrition for Men
Gabie: When you talk about the fertility diet, is it any different for men and women?
Judy: Pretty similar. I want nuts and seeds for both, every day — they're nutrient-dense, with omega-3s and trace minerals. I see so many women taking magnesium supplements, and I tell them, you could get it from nuts, seeds, and whole grains. The same goes for men, and maybe more so — men just get missed on chronic disease.
Women go to the gynecologist regularly. I ask men about their last physical, and they'll say, "Maybe 10 years ago?" They don't go unless something's hurting. So how do you know if you have high blood pressure or pre-diabetes? My concern is that men are often missed. When they go to the fertility clinic, they get a semen analysis — but they should also be told to get a physical and find out they're healthy.
We have plenty of male diet studies showing very similar guidance. We focus a bit more on women in the book because they tend to be the gatekeepers on family health — and we have a lot of single women and lesbian couples too. But just like donor sperm: those men are healthy, they don't let just anyone donate. If you had type 2 diabetes, you couldn't be a sperm donor. Well, you're being the sperm donor for your own child — you should be healthy too.
All the lifestyle factors we talk about in the book — endocrine disruptors, sleep, stress, social support — apply equally to men. We need more men out there talking about it. You should have a man on one of your podcasts.
Gabie: For sure.
Judy: It would really help.
Gabie: I'm really glad you bring up whole-body health. When we were struggling with infertility, my husband had high blood pressure and high cholesterol — nobody ever mentioned a thing. His sperm analysis looked fine, but you can't capture everything on a standard test.
Judy: You really can't.
Gabie: We did a DNA fragmentation test, which looked okay for his age — but again, you can't see everything. Even if a sperm analysis looks fine, that doesn't mean other things going on in your body aren't affecting sperm quality. So I'm so glad you bring this up — it's about the whole body.
Judy: Those little sperm are fragile. They have to come by the millions. New sperm gets made every 70 to 80 days, so why not give it your all for a few months? Half that DNA comes from dad — we want his contribution to be healthier.
Soy: The Misunderstood Superfood
Gabie: You talk a lot about soy in the book, and it was surprising for me. Soy is often highly processed or heavily sprayed with pesticides like Roundup, and it's hard to find good organic soy. So I usually avoid it. Can you talk about the benefits?
Judy: More than 20 years ago there was one small research trial that linked some negatives about soy in men — and that has just stuck, even though it's been disproven since.
For PCOS, we have good studies showing women who eat more tofu, edamame, and tempeh — more soy — improve their biomarkers across the board. That little soybean has the perfect macros: protein, fat, carb, and fiber all built in, plus a lot of good nutrients. Edamame before sushi is super healthy.
Soy is a plant source of protein, and the nutrients in it are beneficial for heart health and diabetes — and anything that helps with chronic disease comes back to help fertility. One caveat: I don't push ultra-processed soy. I encourage people to eat soy like a soybean — edamame, fresh or frozen, great in a stir-fry. We use soy milk at my house. It's just soy and water. Nutritionally, it has the same protein as cow's milk — eight grams — with fewer carbs. The profile is really good.
Think about Asian cultures — tofu has been around forever. People worried we'd "feed too much soy" should look at Taiwan, where people eat tofu for breakfast, lunch, and dinner. There are plenty of children there; it hasn't affected their birth rates.
What else I love about soy: it's inexpensive and easy to cook. I always have frozen edamame in my freezer. On the pesticide concern — buying organic soy isn't hard when you're buying it from the original source. Organic soy milk and organic tofu are easy to find at any grocery store. Tempeh is a great fermented option. Skip the soy crumbles with other additives — just go with the real thing. You can use tofu in Indian, Mediterranean, Thai, and any Asian cuisine. When I'm at a restaurant, I usually pick tofu as my protein.
Then regular beans and lentils — 30% protein, super healthy and inexpensive. People spend so much money on fertility, but if you cook and eat seasonal produce, backed up with frozen when things aren't in season, you don't have to buy $10 blueberries. Right now I'm eating pomegranate, oranges, apples, pears, persimmon — what's seasonal, better priced, and more nutrient-dense than something flown in from South America. Same with vegetables — Brussels sprouts, green beans, winter squashes.
Gabie: Would you encourage people to eat soy even if they can't find organic?
Judy: I would. And the same applies to produce — it's more important that people are eating produce. Some say, "Oh, I can't afford organic," and then they don't eat it. Wash all your produce, even pre-washed bags — rinse with water. E. coli outbreaks happen on organic food too; you have to do the same food sanitation.
When I'm at the farmer's market six months a year, I want to support regenerative farming with organic. Not everybody can afford that. I don't care if you're eating frozen broccoli every night — that's okay. Get the vegetables in. Maybe slightly less vitamin C than fresh, but there's a lot less if you don't eat it at all.
Food gets so confusing for people. You can buy a lot of ultra-processed food that's organic — it doesn't make it healthier.
Gabie: I see that all the time. Even my husband sometimes brings something home and says, "This is organic," and I just say, "Okay."
Judy: It has a health halo it shouldn't have. That's confusing for people.
Alcohol, Caffeine, and Cannabis When Trying to Conceive
Judy: Three months before couples want to conceive is a great time to think about prenatals and what you're eating. It's also a good time to wean off alcohol and cannabis, which isn't easy for everyone. One approach is to slowly decrease.
For my first child, it took seven years. After my period came not pregnant, I'd have some red wine and coffee — then in my ovulatory phase, I'd cut back. There was no real guidance back then. It's frustrating. We don't know exactly, but we do know it's safest to avoid alcohol when actively trying to conceive, and men should minimize too. Cannabis hasn't shown anything positive for fertility. In Seattle, we had early legal access, and I ask everyone now because it's normalized — a lot of people use it. Just being honest, this is a good time to wean down as you're getting ready for pregnancy.
Gabie: Yes — though the hardest part is for people who've been on this journey for years. It's exhausting.
Judy: It's okay to have that glass of wine and have a break. Or someone will tell me, "I'm not drinking any coffee and it's driving me crazy." I tell them, you can have 200 milligrams of caffeine — have a real cup of coffee in the morning if you love it, and maybe decaf in the afternoon. We don't have strong data that moderate caffeine is significantly impacting fertility. The other parts of a healthy diet and managing chronic disease can be more impactful.
When women come to me with repeat pregnancy loss — two, three, four losses — their doctors look at blood sugar and cholesterol. We want to improve all of that. Ideally we'd do this earlier and maybe reduce some of the losses. With many losses, we still have no idea why.
Endometriosis, the Gut, and Diet
Gabie: We touched on PCOS. What do we know about the microbiome and endometriosis? Any diet implications?
Judy: I just got to speak alongside Holly Harris from Fred Hutch and other researchers at the World Endometriosis Society. With endometriosis, we're just learning. Gut dysbiosis — a poor gut microbiome — is potentially both a marker and a driver of endometriosis. It can influence immune function, inflammation, and estrogen metabolism. We're starting to see that more fiber in the diet can help reduce excess estrogen.
So it's similar to PCOS. When you hear about unexplained infertility along with painful periods, endometriosis is so underdiagnosed. We have some data that an anti-inflammatory diet helps, but the gold standard for diagnosis is still laparoscopic surgery — actually seeing the tissue. Sometimes you can see it on imaging, but it's really hard.
Excess estrogen can negatively impact egg quality. With IVF, I have women have their endometriosis surgery first to reduce inflammation in the reproductive system. Endometriosis and PCOS are probably the two major reasons women end up at fertility clinics. I see diet have a more profound effect for PCOS because we have more biomarkers to track and ovulation to follow — endometriosis is harder to measure. But anti-inflammatory eating helps and has no harm.
Gabie: Someone asked: she's been diagnosed with endometriosis, and last week she had yogurt with blueberries for breakfast. It didn't feel good. From what I know, yogurt and kefir are great probiotic foods, rich in fiber, low in lactose. Why might this cause discomfort?
Judy: Good question. Endometriosis is endometrial tissue outside the uterus — on the ovary, fallopian tubes, even the bowel. Some women struggle with irritable bowel syndrome and are more sensitive. Even though there isn't much lactose in yogurt and it has beautiful natural probiotics, I'd suggest trying a lactose-free yogurt — several Mediterranean brands offer it. Or if dairy bothers your skin from high androgens with PCOS, try going without for a month and see how you feel. Same for gut symptoms. They might do well with plain kefir and not that yogurt. I do like to help people get fermented foods like kimchi, yogurt, and try different types of fiber.
Supplements: What's Worth It, What Isn't
Gabie: People often ask about supplements first, even though I think the first question should be what we're not eating that we should be.
Judy: That's right — what should we be including? Nourish first, then supplement.
Gabie: Exactly. For men and women, which top supplements would you usually recommend?
Judy: For most women preparing to conceive, I recommend a full prenatal. I want them getting enough iodine, which is important for thyroid function and fetal brain development. In the last 15 years, supplements started adding iodine because more people are vegan or don't eat fish, and they don't use iodized salt — and our soil is more depleted.
Iron is a maybe — I like to know a woman's iron status. Women with heavy periods may be low and would benefit, but some can't tolerate the iron in supplements. Then they forget, and by the second trimester when they hemodilute, they're anemic. Some preconception supplements have a modest amount of iron.
Honestly, if a woman just starting was eating a great diet, a women's multi with folic acid, a little iron, and iodine would cover the basics — for a fraction of the cost of these designer prenatals.
My concern with some new "everything in a supplement" prenatals is they expect a woman to take eight capsules. You've been pregnant — do you want to take eight capsules when you're nauseous? People can barely take one. I work with people individually. We talk in the book about the basics: iron, folic acid, iodine. From the EARTH study, if you're deficient in B12 or vitamin D, supplementing matters. B12 isn't hard to get from animal products, but vitamin D is widely deficient. Depending on where someone lives, I want a baseline vitamin D draw. Women depleted going into IVF do much better when supplemented — especially women in larger bodies, who sequester vitamin D. If you're going through the expense and intrusion of IVF, you want to know your vitamin D level. But once you have enough, more doesn't make it better.
Gabie: Can you over-supplement?
Judy: Yes. The worst one? Biotin. Some supplements have crazy amounts because people like it for hair and nails. Hardly anyone is deficient in biotin — but the fertility docs and endocrinologists started finding that too much biotin can falsely elevate TSH. If your TSH is high going into IVF, they'll put you on thyroid medication even if you're not hypothyroid. You don't want to start medication for your thyroid because you took too much biotin. I ask women to tell me every supplement they're taking, and I tell them: please don't take the skin and nails biotin.
If we don't have safety data for pregnancy on something — even things like ashwagandha for stress — I tend to be very conservative. I recommend checking with their doctor, because ultimately their doctor is responsible for what they're taking. I look things up in the natural medicines database. A lot of people feel like, "Oh, I'm taking omega-3, I'm taking this supplement, I'm all set" — and their diet is rough. You can't out-supplement a poor diet.
For men, vitamin D if they're not eating fish, maybe omega-3. The male fertility supplement data isn't strong — Cochrane reviews show some may help sperm quality, they won't hurt, but men often think, "I've got my supplement, I'm good," and they don't do any of the other lifestyle work.
Common Behavioral Barriers and Coaching Tips
Gabie: What's the number one behavior you see clients struggle with, and what practical coaching tips help?
Judy: Sleep is huge. People aren't getting enough sleep, then they tell me, "I don't have time for breakfast, I don't have time to meal prep." They're cutting sleep too short and arriving sleep-deprived. We work on prepping for the next day during dinner — talking to your partner, packing lunches — and sleep hygiene. Sleep is foundational.
Another barrier is feeling like they don't have the skills around food — "I have no idea how to cook. We throw things together. We don't eat together." That's why we include culinary tips in week one and suggest taking a knife skills class or watching a video. Learning to cut vegetables properly makes cooking so much more fun. I took a knife skills refresher two years ago after 12 years of teaching cooking classes, and I learned new things I use.
For some, the barrier is access to resources — having enough money for food, or access to the right knowledge. A lot of OBs will say, "Just try for a year, and if you're not pregnant, come back." They should be saying, "This is a good time to look at your lifestyle and get a workup." Even before going off birth control. The whole healthcare team should be involved.
How Long Does It Take to Build New Habits?
Gabie: How long does it take to build stable fertility-supporting habits? People get discouraged thinking it'll take forever.
Judy: In our classes we found that in six weeks we could see behavior changes — eating more regularly, trying new things. When I experimented with stretching it to 12 weeks (a class then a week off), people loved it. They felt like they had more time to practice. So I say six to 12 weeks.
That's why our book is a six-week plan — but if you find week one takes you three times to fully implement, that's great. Take it on your own schedule. We didn't want to overwhelm people in week one. The plan reflects our experience working with women and couples: take a step, try a new recipe, do ten-minute walks. If you're already walking, check that box. We also talk about reducing endocrine disruptors, sleep, and other lifestyle factors. It's amazing what you can do. People say, "I'm doing IVF in a month — is it worth it?" Absolutely. You might also start setting positive habits to carry into a healthy pregnancy.
Where to Find Judy and the Book
Gabie: Where can listeners learn more about your book and get in touch with you?
Judy:Getting to Baby is available at every major bookseller — online or at quite a few independent bookstores. If you have a local independent, ask them to order it. They can follow me or my co-author, Angela Thyer, on Instagram at @FertileNutrition. My website is Mind Body Nutrition. I'm not licensed in every state, but I can work with people across the West Coast and have a strong network of colleagues for referrals elsewhere.
A common question: when does someone need to work with a dietitian? If you have chronic conditions like PCOS and you've never worked with one, even a single session with a dietitian specializing in PCOS and fertility is worth it. I've been training dietitians every year, so there are more of us out there. But you can absolutely start with the book on your own and get a lot of good traction. People can reach out — I'd be happy to help with resources.
Gabie: Amazing. Thank you so much for joining me today and for this wonderful conversation. And thank you to all the listeners — please follow and share the episode with anyone who might benefit.
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