Obesity a major cause for infertility in men, experts say

Overweight and obesity are two health challenges tied together, though in our societies when a person looks flabby, it is usually associated with prosperity.

“It is now very common to hear couples struggle to conceive. We also hear lots of factors contributing to infertility but many of us are not aware that unhealthy eating habits and lifestyle play a huge role in this,” notes Neema Shosho, a nutritionist based in Dar es Salaam.

A diagnosis of male infertility can be one of the hardest challenges a man can face. Not being able to father can make a man feel like he has failed in life.

Jacob Moses, 38, a Dar-es Salaam based businessman, says he has been in marriage for over six years now without a child.

Moses originally blamed his wife before he realised that he had fertility issues.

“In my lifetime, I didn’t know that I was the source of the problem. My wife has been asking me to go for check-up after she had done so but I was not ready for I knew I was fertile,” he says.

Jacob says being a businessperson, he had to travel upcountry regularly and had no much attachment with his family.

He says he was tired of being blamed by family members for the wife’s failure to bear children, because they all believed that she was the source.

“I remember two or three times when my sister accused my wife of being barren. She ordered her to leave the house and let another woman come and bear children,” he says.

Jacob had always had weight issues something that he says even his mother was concerned about as she always advised him to lose weight,

“The day I accepted to go for a medical check-up it was like opening a can of worms. My doctor said my weight was to blame for my infertility. I was weighing 190 kgs,” says Jacob.

How body-weight affects fertility

“Obesity is strongly linked with hormonal imbalance in male, chronic elevation of insulin hormone a condition known as hyperinsulinaemia affects testosterone (male hormone) , which is supposed to be low (in balanced state), when affected becomes predominant in male,” says Dr Boaz Mkumbo, a medical doctor and founder of Healthy Eating Academy.

Dr Boaz explains that insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps to keep your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia.The cells in your body need sugar for energy.

He however, explains that, the main disruptor of hormones in male is sugar when taken from simple sugars (drinks, table sugar and juices) and refined carbohydrates such as wheat bread can affect your body from normal utilisation of insulin hormone a condition known as insulin resistance which is characterised by excessive insulin in the body.

“It is scientifically known that sugar in your blood should range 5gram-10gram in 5-7 liters of blood in an adult, which can be converted to 4.6mmol/L to 5.0mmol/L. In our normal daily life, sugar in our blood is supposed to be one teaspoon to two teaspoon in 5 to 7 liters of blood,” he says.

Because the normal blood sugar range is a fixed value, whatever the amount of sugar you have taken as your diet, the body will need only 1 to 2 tablespoon of sugar to circulate in your blood and the rest will be pushed to storage tanks (fats and glycogen).

For example, you have taken a sugary drink with an average blood sugar of 30 gram. This is equivalent to 6 teaspoon whereby the body will need only maximum of 10 grams, the remaining 20 grams will be stored as fat in large amount for future energy use.

“Your pancreas will keep on helping you use sugar normally throughout your life, therefore excessive sugar consumptions puts you at risk of developing insulin resistance, the main cause of obesity, hypertension, diabetes, heart diseases, erectile dysfunction - all linked to male infertility,” Dr Boaz explains.

Insulin resistance is the chronic condition whereby the body cells cannot use insulin properly and therefore the signal of insulin to body cells is ignored and your body loses ability to use sugar and carbohydrates normally.

He says testosterone is the male hormone, which controls male secondary sexual characteristics including enlargement of male genitals, body power, vitality and desire to have sex. Testosterone is the key male sex hormone that regulates fertility.

He notes that, when levels of testosterone drop below normal levels, they can lead to conditions like hypogonadism characterised by small male genital organs, impotence and mostly of male secondary sexual characteristics are impaired.

There are, however, sources from which people with low testosterone can boost their levels.

Dr Boaz says high or low levels of testosterone can lead to dysfunction in the parts of the body normally regulated by the hormone.

He says when a man has low testosterone or hypogonadism, he may experience reduced sex drive, erectile dysfunction and low sperm count and therefore may become infertile unless treated.

The effects of insulin

When you are overweight or obese, your body is exposed to excessive insulin that’s why you experience difficult in losing weight whatever you struggle because insulin prevents your body from using the stored fat.

This condition may affect the production of testosterone and hence have low sperm count, low sexual drives and body power.

Apart from that excessive insulin exposure may also cause oestrogen hormone, predominant in male which is not supposed to be detected high in male since it controls female secondary sexual characteristics such as breast and hips enlargements, menstruation cycles etc. This condition is linked to central obesity in male, low male sex hormones, enlargements of breast in male and small genitalia.

Generally, most of undiagnosed causes of infertility in males are hormonal related.

Dr Boaz says sometimes when a man weighs extra kilograms, he will always experience chronic body fatigue sometimes accompanied with pain, a situation that will lead him lose desire for sexual intercourse.

Healthy lifestyle

Here are some of the lifestyle changes Dr Boaz suggests:

• Get involved in healthy eating lifestyle, to boost your testosterone level and avoid excessive sugar and refined carbohydrates consumption.

This will help you sensitise your body and lose your extra pounds without struggle. Losing weight will not only make you lighter but also increases your fertility.

He argues that making these changes, a man will get other health benefits as well, explaining that he may lower his risk of other diseases, and will probably feel better and have more energy.

They should also eat a variety of foods from each food group, including whole grains, fruits with low sugar value such as avocado, cucumbers, strawberry and blueberries and vegetables.

In addition, research has shown that excessive omega 6 ratio compared to omega 3 drives insulin resistance a condition linked to infertility.

Therefore avoiding Omega 6 rich seed oils and fats loaded with free radicals such as margarine [blueband] which should go concurrently by increasing omega 3 rich foods such as a handful of tree nuts, cashew nuts, almond seeds, Chia seeds as well as eggs, grass fed beef, free range fish so that to boost your testosterone level.

• Exercise has many health benefits, including helping one to lose weight and lower their blood sugar levels. Also helps to boost testosterone level to people with condition of infertility.

• Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If one already smokes, one should try to quit.

The exercise should go with taking balanced diet because exercising makes testosterone hormone high.

• Avoid stress, when you are chronically stressed, cortisol hormones (Stress hormones) lower your testosterone and may cause infertility. Apart from that, chronic stress is linked to obesity, chronic fatigue accompanied with generalised body pain.

• Engage in Yoga and meditation, which are the main tools for stress management as compared to aerobics, cardiac and resistance exercises.

Not a woman’s problem only

Dr Boaz advises men not to think, ‘there is a magic pill or herb that can cure infertility’. The permanent and definitive solution to conquer your problem is to adopt healthy lifestyle changes, healthy foods can help you reclaim your health by dealing with your body as whole.

However talking about why most men fear to seek medical check-up, the expert says most of them feel that they are superior to their wives, thus seeking medication would be akin to losing dominance.

“Most men can stay with healthy problems without wanting to inform their wives. They mostly think by divulging secretes they would destabilise their families and conjugal affairs,” says Dr Boaz.

He notes that in the past infertility was a problem that was associated with women, the situation that caused family separation but now days a few men seek medical advice in case infertility persists.

Most Tanzanian men don’t realise that the problem might start with them.

A nutritionist’s take

On her part, Ms Neema Shosho, a nutritionist says, it is now very common to hear couples struggle to conceive.

“If not done in a healthy way, unhealthy eating and lifestyle can highly damage your reproductive system so precautions should be taken. For men specifically, studies have proven that young men of reproductive age have low sperm count than their fathers and grandfathers had at this age,” says Ms Shosho.

What is contributing to this then?

Ms Shosho sheds light to some of the other contributing habits to male infertility:

• Alcohol consumption: excessive consumption of alcohol is named to be toxic and can affect sperm production as well as causing hormonal imbalance.

Ms Shosho says alcohol not only leads to erectile dysfunction, it can also affect the quality of your semen and the production of sperm through abnormal hormone fluctuations.

• Same effects are observed in men who smoke. Smoking is linked to damaged sperm.

• She notes that weight gain has tremendous effects to a man’s reproductive health. It affects men’s hormonal balance, throwing sperm production off. There’s also evidence that being overweight can make it difficult to achieve an erection or even want to have sex.

“We know this is sensitive so if a man wants to keep his virility, he should make sure that his BMI is ideal,” she says.

• In addition to the above two key factors, the following factors are also named to play part to male infertility;

Tight pants and underwear. This increases the scrotal temperature which can result in a decrease in sperm production as sperms survive better at low temperature. This is important for those wearing very tight pants and underwear. Let it free.

• “Excessive stress although correlation between stress and infertility is not that clear, researchers did suggest the sperm could be harmed by stress-related hormone changes, or an increase of stress-related free radicals that harm cells”.

Key message

“Eat balanced diet, manage your weight, maintain ideal BMI, drink alcohol in moderation and smoking should be a No No to them, avoid stress, remember to exercise and keep fit,” Dr Boz advises.