Judging a Book by Its Cover (and Its Website): "The Fertility Diet"

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Infertility is a serious issue for many women and it rarely has an easy explanation or a quick fix. Frustrated by years of uncertainty and difficult treatments, women experiencing unexplained fertility problems can be particularly susceptible to claims of miracle cures. If they believe the book The Fertility Diet, they also have a new enemy to contend with: trans fats.

A review of the book in the Spring/Summer 2008 issue of the Harvard Public Health Review sums up its findings as, "women may be able to increase their chances of getting pregnant by avoiding trans fats, eating more beans, nuts, and other plant proteins, embracing whole grains such as oatmeal and barley, and having a glass of whole milk or other full-fat dairy product every day."

Emblazoned with Harvard Medical School's crest, the book's cover offers the subtitle, "Groundbreaking Research Reveals Natural Ways to Boost Ovulation and Improve Your Chances of Getting Pregnant." What it doesn't say is that the findings are based on a subset of the Nurses' Health Study consisting of 400 women with ovulatory infertility, a condition caused by irregular ovulation that affects less than a third of infertile women. Further, the conclusions the authors draw are based on an observational epidemiologic study, which depends on the participants' reports of their lifestyle characteristics (diet, exercise, etc.). Other researchers must replicate such data before its conclusions can be assumed to be correct.

To be fair, the authors have made clear in interviews that they are aware of the limitations of their findings. Just a little Internet research is all it takes to find them making statements like this one from lead author Dr. Jorge E. Chavarro: "I would describe it as an apparently fertility-enhancing dietary pattern...not a cure for infertility." I do not wish to accuse the authors of conducting a suspect study or blinding themselves to the problematic elements of their research.

My criticism lies with the book's marketing. Nowhere does the website for The Fertility Diet even suggest that the book's recommendations may not be medically relevant for all women. In fact, it does just the opposite, claiming, "Now there's a safer, natural, and virtually free way to improve fertility that's available to all."

For centuries, women were blamed for problems with their fertility or pregnancies. The belief that diet and exercise will boost a woman's chance of getting pregnant comes dangerously close to blaming her "bad choices" for any difficulty encountered in conceiving. Promoting The Fertility Diet on a large scale -- rather than as medical findings that are helpful and relevant to only some women -- is irresponsible, as it presents infertility as something women can (and should) "fix" if only they try hard enough.

I am judging this book by its cover because that is clearly how it wants to be judged by the hopeful, sometimes desperate women who will buy it only to discover its "miracle cure" doesn't apply to them. Women must already struggle with reactions ranging from disappointment to disbelief to degradation when they cannot (or choose not to) have children. This book's authors and their publicists shouldn't increase the guilt infertile women may already feel, shaming them for eating trans fats on the basis of such preliminary findings.

Elizabeth Wade is a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).