PRECONCEPTION NUTRITION: STARTING FROM THE BEGINNING

These evidenced based recommendations should be on every couple’s radar before trying conceive.

It is widely known that what we eat, drink and our lifestyle choices during pregnancy is important and impact a baby’s long term health. However what isn’t widely known is the impact begins prior to conception. Preconception nutrition, at least three months before an egg is fertilized, should be prioritized but the more time you can give yourself the better. This is because a women’s eggs follow a 90 day cycle and for men approximately 64 days for a full sperm reproduction. During this time, diet and lifestyle choices influence gene expression and therefore disease risk. From the moment an egg is fertilized, requirements for specific nutrients increase for fetal growth. Nutrient requirements continue to increase throughout pregnancy and breastfeeding. Therefore understanding where your nutrition stores lie prior to conception is important as it is not uncommon for women and men to need to correct deficiencies.

From the moment of fertilization the baby’s genetic make-up is complete, they have all the genetic code required for embryo growth. Researchers have discovered that the first 1000 days are a crucial window of time to reduce the risk of obesity, type 2 diabetes, heart disease and allergies. We also now know that development and long term health is only moderately determined by genes and significantly influenced by nutrition and lifestyle factors throughout pre-conception, pregnancy, infancy and early childhood.

Why you should get a health check

Optimizing general health before pregnancy is vital. There are many nutrient deficiencies and medical conditions that can affect fertility. Some are obvious whilst others are silent. For example, you may have low levels of vitamin D and not know unless this is specifically checked. Low levels of Vitamin D are associated with lower levels of fertility and ovulation. Pregnant women with insufficient Vitamin D levels had an increased incidence of Gestational Diabetes, pre-term delivery and loss of pregnancy.

Similarly, optimal iron stores before pregnancy is of extreme importance. Iron deficiency during pregnancy is common due to the increased requirements. Optimum iron levels can be achieved through increased consumption of lean meat, legumes, whole grains and green, leafy vegetables. Iron supplements may also be effective if required but again; best started prior to conception than during pregnancy. This will also avoid symptoms of constipation which can be exacerbated during pregnancy making eating a balanced diet during pregnancy very challenging.

You will also want your GP to investigate thyroid function, Iodine, Zinc, Folate, B12, blood sugar control, hormonal conditions and Insulin Resistance. These conditions are common in women who are overweight and therefore play havoc with hormones making it more challenging to conceive. Equally, Endometriosis and Coeliac disease can impact fertility, pregnancy and health outcomes in babies.

A prenatal dietitian may help you reduce the effects of these medical conditions and optimize your diet accordingly. This is done by collating all your medical and diet history, then tailoring a diet and supplementation plan. Prenatal supplementation should begin at least three months prior to conception to optimize nutrition stores, reduce risk of neural tube defects and improve quality of egg and sperm health

Weight

In Australia, we are experiencing a significant increase in overweight/ obese adults and children. According to the Australian Institute of Health and Welfare, 1 in 3 adults are obese and 1 in 4 children are overweight or obese. Being overweight or underweight also affects fertility and pregnancy outcomes. Hormonal disorders such as PCOS can make losing weight difficult. If you need to increase or reduce body fat – don’t get lured into a FAD diet. Restrictive diets are usually not fertility friendly.

Nutrition and lifestyle tips to enhance your diet before conception and during pregnancy

1. Eat whole foods and less foods wrapped in plastic, avoid foods containing artificial sweeteners, colors and preservatives which may disrupt the endocrine system responsible for hormone production, circulation and regulation. Instead visit your local market and explore the fresh and organic produce selection.

2. Diversify your diet- focus on consuming plant based foods to maximize the intake of important nutrients for pregnancy. This includes folate, iodine, antioxidants, and fibre which support the gut microbiome needed to develop baby’s gut too.

3. Increase dietary consumption of Choline, an essential nutrient required for a baby’s brain development and linked to higher cognition in infants. Currently, only 1% of Australian mothers are meeting their choline requirements during pregnancy. Choline is found in eggs, red meat, poultry, bread, cereals and nuts. (Tip: Just two eggs will provide 50% of a mothers daily choline requirements.)

4. Eat less highly processed meats, in particular deli meats. When consumed regularly, research showed a reduction in healthy sperm and a 40% higher risk of ovulatory dysfunction in women. 6. Eat oily fish like salmon, mackerel and sardines at least twice a week. Oily fish are great source of Omega3 fatty acids. Studies have shown these fatty acids assist with fertility and are essential for brain development. Guided supplementation can also help.

7. Don’t cut out whole food groups- I commonly see dairy and gluten avoided. Unless you have been medically diagnosed or have an intolerance to these food groups, this is not recommended as you will most likely be cutting out other major foods groups if not done with caution and assistance. These food groups play an important role in the development of a healthy gut and immune system. They contain prebiotic bacteria that are also high in fibre, such as sourdough and seeded breads. These nutrients can have a significant reduction in allergy development in infants, particularly eczema, when consumed and supplemented in the third trimester of pregnancy.

8. Reduce or avoid alcohol consumption for both male and females.

9. Quit smoking- smoking is detrimental to fertility. Sperm and egg health and fetal development can be significantly impacted.

10. Book in to see your GP and a Prenatal Dietitian to screen for any underlying medical issues, examine your nutrient stores, and look at starting a tailored supplement/diet plan.

Understanding this information empowers couples to be more proactive about their health. Seeking the right health professionals to be a part of your team before, during and after pregnancy can help prevent adverse health outcomes.