Pregnant and breastfeeding women should probably be advised to either decrease or, when possible, cease cannabis use entirely, and couples trying to conceive may also want to consider cutting down. 

Approximately one in six couples “are unable to conceive after a year and are labeled infertile, with a male factor identified in up to half of all cases.” Several lifestyle factors have been associated with diminished sperm production, such as smoking cigarettes, but what about smoking cannabis? 

“Regular marijuana smoking more than once per week was associated with a 28%…lower sperm concentration,” as well as a lower total sperm count based on a study of more than a thousand men, but “no adverse association was found for irregular use” of less than once a week.  

As I discuss in my video The Effects of Marijuana on Fertility and Pregnancy, this wasn’t a randomized study, so other factors that go along with regular marijuana use may have been to blame. Researchers did take into account cigarettes, alcohol, other drugs, STDs, and things like that, but there’s always a possibility there was something else for which they didn’t control. 

Findings were similar for women. Hundreds of infertile couples were studied in California, and, just as men had about a quarter fewer sperm, a quarter fewer eggs were retrieved from women who used cannabis more than 90 times in their lifetime or had been using the year before. Again, there could have been confounding factors, but until we know more, couples who are trying to conceive may want to make the joint decision to turn over a new leaf.  

What about during pregnancy? As you can see below and at 1:39 in my video, medical authorities recommend that “women who are pregnant or contemplating pregnancy should be encouraged to discontinue marijuana use” and not use it during pregnancy or lactation, though the Academy of Breastfeeding Medicine suggests the known benefits of breastmilk currently outweigh any potential harms for women who continue to smoke it. Despite these warnings from authorities, marijuana use has increased among pregnant women in recent years, going up by more than 60 percent, but that’s only from about 2.5 percent up to less than 4 percent, which is less than half the frequency of nonpregnant women. 

Why are OB/GYNs so down on getting high? Scary articles appear in the American Journal of Obstetrics and Gynecology, like one making claims that a “large study conducted by the US National Birth Defects Prevention Center documented a significantly increased risk for anencephaly [a serious birth defect] when the fetus is exposed to marijuana during the first month of gestation.” But, if you don’t just take their word for it and pull up the actual study, you’ll see that the association wasn’t statistically significant after all. As one letter to the editor was titled, “Marijuana and Pregnancy: Objective Education Is Good, but Biased Education Is Not.”  

Some risks have been identified: Infants “were more likely to be anemic, and…have lower birth weight and to require placement in neonatal intensive care than infants of mothers who did not use marijuana.” However, it’s “difficult to determine the direct effects of maternal cannabis use on the developing fetus” because of a variety of confounding factors for which studies may not be able to completely control. 

Studies also show links between prenatal marijuana exposure and learning problems later in life—manifesting years later in school—and that’s where the greater concern lies, on the potential long-term effects on brain development. So, even after “weeding out the myths,” there is enough concern that “pregnant and breastfeeding cannabis users should be identified early and advised to either decrease or where possible cease cannabis use entirely.” 

When do I mean by cut down “when possible?” Check out my video Natural Treatments for Morning Sickness to see how marijuana use during pregnancy can sometimes be a lifesaver. 

I originally released several videos on cannabis in a webinar and downloadable digital DVD. If you missed any of them, they are listed in the related videos below.  

For more on fertility, check out Male Fertility and Diet and Dairy Estrogen and Male Fertility. 

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If extra chewing is effective in suppressing your appetite when it comes to food, what about chewing gum as a weight-loss strategy? 

As I discuss in my video Does Chewing Gum Help with Weight Loss?, chewing gum may only burn about three calories an hour, but the calorie expenditure isn’t only working your little jaw muscles. For some reason, chewing gum revs up your heart rate as much as 12 extra beats per minute after chewing two sticks of gum, even if you’re just sitting quietly, as you can see in the graph below and at 0:21 in my video. It also works while walking, increasing your heart rate by about three more beats per minute (and proving scientifically that people can indeed walk and chew gum at the same time).  

Does this translate into weight loss? Researchers at the University of Buffalo asked study participants to either chew gum before every single eating occasion or not chew any gum at all for a number of weeks. On the gum-chewing weeks, the subjects didn’t just have to chew gum before each meal, but also before each snack or drink that contained any calories. That may have been too much, so the participants actually ended up eating on fewer occasions, switching from four meals a day on average down closer to three. They ended up eating more calories at each of those fewer meals, though, and had no overall significant change in caloric intake and, no surprise, had no change in weight. See the charts below and at 1:08 in my video. 

University of Alabama researchers tried a different tack, randomizing people to chew gum after and between meals. After two months, compared to those randomized to avoid gum entirely, no improvements were noted in weight, body mass index (BMI), or waist circumference. However, some studies have suggested that chewing gum has an appetite-suppressing effect. For example, as you can see below and at 1:51 in my video, in one study, people ate 68 fewer calories of pasta at lunch after 20 minutes of chewing gum, but other studies have shown differently. 

Whenever there are conflicting findings, instead of just throwing up our hands, it can be useful to try to tease out any study differences that could potentially account for the disparate results. The obvious consideration is the funding source. That failed University of Alabama weight-loss study was funded by a gum company, so the outcomes are not necessarily predetermined. 

As well, different types of gum using different sweeteners may have contributed to the diversity of findings. As you can see in the graphs below and at 2:35 in my video, a study that found that chewing gum may actually increase appetite was done with aspartame-sweetened gum. People reported feeling hungrier after chewing the sweetened gum—and not only compared to no gum, but compared to chewing the same gum with no added aspartame. It’s true that not one randomized controlled trial has ever shown a benefit to “chewing gum as a strategy for weight loss,” but they all used gum containing artificial sweeteners.

There was a landmark study that showed that the size of a sip matters when it comes to reducing the intake of sweet beverages. When study participants took one sip every two seconds or a quadruple-sized gulp every eight seconds, but with the same ingestion rate of 150 grams per minute, the smaller sip group won out, satiating after about one-and-a-half cups compared to two cups when taking larger gulps, as you can see in the graph below and at 3:13 in my video. This is thought to be because of increased oro-sensory exposure, so our brain picks up the more frequent pulses of flavor and calories. But repeat the experiment with an artificially sweetened diet drink, and the effect appears to be blunted, as you can see in the graph below and at 3:38 in my video. So, might a different type of gum have a different effect? The positive pasta study I discussed earlier was performed using gum sweetened mainly with sorbitol, a sweet compound that’s found naturally in foods like prunes, and, like prunes, can have a laxative effect.

Case reports like “An Air Stewardess with Puzzling Diarrhea” unveil what can happen when you have 60 sticks of sorbitol-sweetened sugar-free gum a day. Another report was entitled “Severe Weight Loss Caused by Chewing Gum.” A 21-year-old woman ended up malnourished after suffering up to a dozen bouts of diarrhea a day for eight months due to the 30 grams of sorbitol she was getting chewing sugar-free gum and candies every day. Most people suffer gas and bloating at 10 daily grams of sorbitol, which is about eight sticks of sorbitol-sweetened gum, and, at 20 grams, most get cramps and diarrhea. So, you want to be careful how much you get. 

The bottom line is that we have no good science showing that chewing gum results in weight loss. Could that be because the studies used artificial sweeteners that “may have counteracted” any benefits? Maybe, but the most obvious explanation for the results to date “is that chewing gum simply is not an efficacious weight-loss strategy”—and that’s coming from researchers funded by the gum company itself. 

How Many Calories Do You Burn Chewing Gum? Watch the video to find out. For information on both artificial and natural low-calorie sweeteners, check out the related videos below.

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Plant-based diets are the single most important—yet underutilized—opportunity to reverse the pending obesity and diabetes-induced epidemic of disease and death. 

Dr. Kim Williams, immediate past president of the American College of Cardiology, started out an editorial on plant-based diets with the classic Schopenhauer quote: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.” In 2013, plant-based diets for diabetes were in the “ridiculed” stage in the official endocrinology practice guidelines and placed in the “Fad Diets” section. The guidelines acknowledged that strictly plant-based diets “have been shown to reduce the risk for T2DM [type 2 diabetes] and improve management of T2DM” better than the American Diabetes Association recommendations, then inexplicably went on to say that it “does not support the use of one type of diet over another” with respect to diabetes or in general. “The best approach for a healthy lifestyle is simply the ‘amelioration of unhealthy choices’”—whatever that means. 

But, by 2015, the clinical practice guidelines from the same professional associations explicitly endorsed a plant-based diet as its general recommendation for diabetic patients. The times they are a-changin’! 

As I discuss in my video Plant-Based Diets Recognized by Diabetes Associations, the American Diabetes Association itself is also now on board, listing plant-based eating as one of the dietary patterns acceptable for the management of the condition. The Canadian Diabetes Association, however, has really taken the lead. “Type 2 diabetes mellitus is considered one of the fastest growing diseases in Canada, representing a serious public health concern,” so it isn’t messing around and recommends plant-based diets for disease management “because of their potential to improve body weight and A1C [blood sugar control], LDL-cholesterol, total cholesterol and non-HDL-cholesterol levels, in addition to reducing the need for diabetes medications.” The Canadian Diabetes Association uses the Kaiser Permanente definition for that eating pattern: “a regimen that encourages whole, plant-based foods and discourages meats, dairy products and eggs, as well as all refined and processed foods,” that is, junk. 

It recommends that diabetes education centers in Canada “improve patients’ perceptions of PBDs [plant-based diets] by developing PBD-focused educational and support as well as providing individualized counseling sessions addressing barriers to change.” The biggest obstacle identified to eating plant-based was ignorance. Nearly nine out of ten patients interviewed “had not heard of using a plant-based diet to treat or manage T2DM.” Why is that? “Patient awareness of (and interest in) the benefits of a plant-based diet for the management of diabetes…may be “influenced by the perception of diabetes educators and clinicians.” Indeed, most of the staff were aware of the benefits of plant-based eating for treating diabetes, yet only about one in three were recommending it to their patients.  

Why? One of the common reasons given was they didn’t think their patients would eat plant-based, so they didn’t even bring it up, but “[t]his notion is contrary to the patient survey results that almost two-thirds of patients were willing” to at least give it a try. The researchers cite the PCRM Geico studies I’ve covered in other videos, in which strictly plant-based diets were “well accepted with over 95% adherence rate,” presumably because the study participants just felt so much better, reporting “increased energy level, better digestion, better sleep, and increased satisfaction when compared with the control group.” 

A number of staff members also expressed they were unclear about the supportive scientific evidence as their second reason for not recommending this diet, but it’s been shown to be more effective than an American Diabetes Association–recommended diet at reducing the use of diabetes medications, long-term blood sugar control, and cholesterol. It’s therefore possible that the diabetes educators were simply behind the times, as there is “a lag-time” in the dissemination of new scientific findings from the literature to the clinician and finally to the patient. Speeding up this process is one of the reasons I started NutritionFacts.org. 

As Dr. Williams put it, “the ‘truth’ (i.e., evidence) for the benefits of plant-based nutrition continues to mount. This now includes lower rates of stroke, hypertension, diabetes mellitus, obesity, myocardial infarction, and mortality [heart attacks and cardiac death], as well as many non-cardiac issues that affect our patients in cardiology, ranging from cancer to a variety of inflammatory conditions.” We’ve got the science. The bigger challenge is overcoming the “inertia, culture, habit, and widespread marketing of unhealthy foods.” He concludes, “Reading the existing literature and evaluating the impact of plant-based nutrition, it clearly represents the single most important yet underutilized opportunity to reverse the pending obesity and diabetes-induced epidemic of morbidity and mortality,” disease and death. 

I highlighted the PCRM Geico studies in my videos Slimming the Gecko and Plant-Based Workplace Intervention. 

Aren’t plant-based diets high in carbs? Get the “skinny” by checking out my video Flashback Friday: Benefits of a Macrobiotic Diet for Diabetes. 

To learn more about diet’s effect on type 2 diabetes, see the related videos below. 

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