consultant  commentary

Dr Ravi Akambaram
Place of Work:
Family Physician, Klinik Kumpulan Utara, Southern Park
Ravi Akambaram,, The metabolic health evidence and its link to better reproductive health and fertility. Consultant Commentary, 2020;(2):


A literature review in The American Journal of Obstetrics and Gynecology revealed the relationship between diet and human fertility has greatly expanded over the last decade, resulting in the identification of selective clinical nutrition as adjunct therapy. The cumulative evidence also supported the popular hypotheses of food intolerance as cause of chronic inflammation.

Adherence to plant based diets favoring whole grains proteins, omega 3 seeds, dietary fiber from vegetables, fruits and tubers, vitamins and trace elements from mushrooms enhanced reproductive health in both sexes.

Metabolic Syndrome X has several causes that act together: overweight, chronic stress, eating disorder, food intolerance, alcoholism, smoking, imbalance of beneficial gut bacteria (dysbiosis), Insulin resistance, (cells unable to use insulin properly), lack of exercise and disturbed sleep.

Metabolic Syndrome X can have adverse effects on women's reproduction by affecting their fertility directly or indirectly by interfering with the pituitary-hypothalamic function or ovarian functions.2

Medical conditions that adversely affect women’s fertility are constipation, insulin resistance, obesity, hyperlipidemia, PCOS, impaired ciliary function, pelvic inflammatory disease, other endocrine and hormonal disorders and premature menopause / ageing.2

Medical conditions that adversely affect men’s fertility are insulin resistance, hypertension, high LDL cholesterol, fatty liver, UTI, inflammation of the prostate and ED resulting in lower sperm count.

The optimal approach for preventing Metabolic Syndrome X is to lose excess weight more so visceral fat, case evidence in our clinic shows dropping 5% body fat within 30 days is associated with a lower risk profile and 20% increase in energy levels (improved moods).                          

Regular exercise (5000+ steps per day) combined with a low glycaemic diet, like the Gluten Free Ketogenic Meal is a Vegan food that focuses on reducing inflammation, easing bowel movement and regulating blood glucose and blood lipids.  

This nutritionally complete meal is suitable for patients with food intolerance.3  This adjunct therapy focuses on providing patients with essential nutrients for recovery and proper functioning. This real meal contains resistant starch and dietary fiber that is important for a healthy colon.

The prebiotics feeds the colon’s natural gut bacteria to produce a host of metabolites such as essential short chain fatty acids and enzymatic cofactors that improves our digestive function. Our endocrine system use these biogenic metabolites to regulate sexual function, menstruation and reproduction (pregnancy).3

Micro capillaries (angiogenesis) and cellular metabolism function better during Nutritional Ketosis.4  Gluten Free Ketogenic Meal composed primarily of ancient whole grains and polyphenols holds much promise in modulating fertility.


  • 1.     Audrey J. Gaskins, Jorge E. Chavarro, Diet and fertility: a review, American Journal of Obstetrics & Gynecology, August 24, 2017

  • 2.     Ahmed Al Awlaqi, Khalid Alkhayat,Mohamed E. Hammadeh., Metabolic Syndrome and Infertility in Women Department ofO&G; University of Saarland; Homburg/Saar, Germany IJWHR., July 2016; 4:089-095
  • 3.     Monika Petruláková, Ľubomír Valík, Food allergy and intolerance,Department of Food Nutrition and Assessment, Institute of Biochemistry June 2015 Acta Chimica Slovaca 8(1):44-51
  • 4.     Victoria M. Gershuni, Stephanie L. Yan, Valentina Medici, Nutritional Ketosis for Weight Management and Reversal of Metabolic Syndrome Curr. Nutr. Rep. 2018 Sep; 7(3): 97–106.
dr Ravi Krishnapillai
MBBS  FRCS (neuro)
Place of Work:
Ravi Krishnapillai, et al., The Gut to Brain connection, change what you eat. Consultant  2020 (1)

A review in the Journal Nutritional Neuroscience revealed, regular eating of fruits, whole grains and veggies presents ‘a non-invasive, naturally safe and inexpensive therapeutic means to support brain health (neuro-protective) 2

The gut-brain axis (GBA) is a bidirectional link between the central nervous system (CNS) and the enteric nervous system(ENS) of the body. It involves direct and indirect pathways between cognitive and emotional centers in the brain with peripheral intestinal functions. Jun 27, 2017

Recent advances in research have described the importance of gut microbiome in influencing these interactions. “Growing Body of research linking ageing process and age-related cognitive decline with changes in colon microbes.” “Recently, the existence of two-way communication between the gut and the brain – known as the 'gut-brain axis' – has emerged as an important findings in shaping aspects of behavior and cognitive function.” says David Vauzour, co-senior author on the new study. 3

Research has uncovered a number of intriguing links between the gut microbiome and the brain. Depression, Dementia and even personality traits have all been found to be somewhat associated with highly processed foods and depletion of our gut bacteria.

Biologically active peptides have been instrumental in the formulation of the concept that brain and gut have much in common. When in the 1970s several peptides were discovered to occur both in the brain and gastrointestinal tract, the term ‘gut-brain axis’ was first coined, based on the prevailing concept that the brain would be essential for controlling gut function. 4

On the other hand, we've also seen metabolites produced by pathogenic gut microbe traveling up into the brain and exacerbating neurovascular disease. So it seems increasingly clear the gut-brain axis is both incredibly complex and deeply bi-directional.

Metabolites derived from fermentation of phytonutrients by gut bacteria produce hundreds of neurochemicals that the brain uses to regulate basic physiological processes as well as mental processes such as learning, memory, mood and reproductive urge. For example, gut bacteria manufacture about 95 percent of the body's supply of serotonin, which influences both mood and GI activity.

Nutritional Ketosis purportedly works by increasing ketone bodies and remodeling the gut’s microbial population to subsequently reduce neuroinflammation associated with cognitive decline.

Gluten Free Vegan Keto Meal composed primarily of ancient whole grains holds much promise in modulating ‘gut-brain axis’. Resistant Starch an integral component of this diet is fuel for our ancient microbes that helps restore the metabolic health of our second brain the colon.

  • 1.     MishraS, Xu J, Agarwal U, Gonzales J, Barnard ND, A multicenter randomized controlled trial of a plant –based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr.2013;67(7):718-24

  • 2.     Gomez-Pinilla F, Nguyen TTJ.  Natural mood foods: the action of polyphenols against psychiatric and cognitive disorders. J. Nutr-Neurosci. 2012;15(3):127-33
  • 3.     Cristina Angeloni, Rita Businaro, David Vauzour.The role of diet in preventing and reducing cognitive decline. Article, Norwich Medical School. Mar 2020
  • 4.     Peter Holzer and Aitak Farzi, Neuropeptides and the Microbiota-Gut-Brain Axis Adv.Exp. Med Biol. 2014; 817: 195–219.
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