A healthy start: fertility nutrition
Despite some factors that are out of your control when it comes to the health of your future baby (such as genetics, age and family history), there are a lot of things that are within your control. Creating healthy eating habits now during the preconception period, is one of them.
A healthy diet is based on a balance of three macronutrients namely;
- carbohydrates
- protein
- healthy fats
Macronutrients are the primary building blocks for our diet and are the essential nutrients we need in larger quantities to provide us with energy.
What are micronutrients?
Vitamins and minerals are referred to collectively as ‘micronutrients’ and have a significant impact on your health, the development of your future baby and its’ lifelong health outcomes.
In the first trimester of pregnancy alone, the fetal mass increases over 2.5 million times, as cells multiply rapidly to form all the baby's bodily organs. This phenomenal rate of growth has exceptional nutritional requirements so it is of the utmost importance that you are already fuelling your body in preparation for this. The best way to guarantee that you are getting a consistent dose of micronutrients is to focus on eating a wide variety of whole foods.
UNDERSTANDING KEY NUTRIENTS
The difference in caloric intake between a non-pregnant and a pregnant woman does not increase as much as most people think. Yet, the micronutrient intake will dramatically increase during pregnancy.
During the first trimester you may experience symptoms such as morning sickness (which can occur at any time of the day) and exhaustion. You may even suddenly have a strong aversion to the smell of certain foods that you used to love. Dry crackers, while helpful for morning sickness, certainly do not contain enough nutrients to grow a baby. This is another reason it is so important that you have your micronutrient stores built up and have any deficiencies identified and resolved prior to pregnancy.
While all the micronutrients play various individual and collective roles in reproductive health, there are a few in particular that stand out as key nutrients for foetal development that you can start eating now in order to build up your reserves.
Folic Acid
The terms ‘folic acid’ and ‘folate’ are both used to describe the Vitamin B9, but they are not technically the same. Folate is a ‘natural’ form of Vitamin B9 found in leafy green vegetables such as spinach, whereas folic acid is the synthetic form of Vitamin B9 and is found in most prenatal vitamin supplements and added to processed/fortified foods.
Folic acid is recommended to all women while they are trying to conceive as during the first 12 weeks of pregnancy, it plays an integral part in the formation and development of the neural tube and for the prevention of birth defects such as spina bifida and anencephaly.
While both folic acid and folate will ultimately be converted into methylfolate (the form our body can use), some people can have a defect that means this process is affected, and therefore may require a specific form of Vitamin B9 supplementation known as an ‘activated form’.
Iron
Your body uses iron to make haemoglobin - a substance in red blood cells that moves oxygen throughout your body. Iron is very important during pregnancy as it is also responsible for delivering oxygen to your baby.
If you’re scheduled for a preconception checkup, ask your doctor if you should be screened for an iron deficiency. Too little iron could increase your baby’s risk of being underweight and affect their IQ. Take note, there are many different types of anaemia, not just iron deficiency anaemia. It is important for your healthcare practitioner to rule out other types of anaemia such as those seen in B12 deficiency and thalassemia.
Vegans, vegetarians, and people with significant gastrointestinal or absorption issues may need to include more iron-rich foods into their diet. Plant-based iron has a lower bioavailability compared to animal-based sources.
Vitamin D
Vitamin D plays a vital role in fetal skeleton development, immune function, gene expression and hormone secretion. Vitamin D also regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy.
Regular sun exposure is the most natural way to get Vitamin D. To maintain healthy blood levels, aim to get 10 to 30 minutes of midday sunlight, several times per week. People with darker skin may need a little more than this. Always ensure that you use protection against the sun's UV rays by wearing sunscreen and a hat.
Whilst sunshine is a natural source of Vitamin D it is not always available in places like the UK! Additional sources of Vitamin D can be found in oily fish (such as salmon, sardines, herring and mackerel) and egg yolk.
Vitamin A
Vitamin A is an essential nutrient for normal cellular function, including reproduction and development. Vitamin A is the name of a group of fat-soluble retinoids; including retinol, retinal, and retinyl esters. Vitamin A is critical for vision because it supports the normal differentiation and functioning of the conjunctival membranes and cornea.
Vitamin A also supports cell growth and differentiation; playing a critical role in the normal formation and maintenance of the heart, lungs, kidneys, and other organs. However, too much of the wrong type of Vitamin A can actually be harmful to you and your developing baby.
It is important to differentiate between the types of Vitamin A. Vitamin A is found naturally in certain foods, but can also be synthetically made. It is these synthetic forms of Vitamin A that the majority of toxicity warnings is based upon and should be avoided during preconception and pregnancy. It is therefore best to focus on getting natural Vitamin A from real food such as carrots, mango, sweet potato and butternut squash.
Calcium
Calcium offers protection against pre-eclampsia in pregnancy and supports skeleton development and muscle and nerve transmission within the fetus. Calcium also keeps your reproductive system functioning smoothly and may even help you conceive faster. If your stores are low when you’re pregnant, your body will take the calcium directly from your bones and give it to the developing baby, which might raise your risk of osteoporosis (brittle bones) in the future.
Omega-3 fatty acids
Adequate consumption of omega-3 fatty acids is vitally important during conception and pregnancy as they are critical building blocks for fetal brain and retina development. Omega-3 fatty acids has been shown to help regulate key ovulation-inducing hormones and increase blood flow to the reproductive organs.
Iodine
Iodine is essential for the production of maternal and fetal thyroid hormones that regulate the development of the fetal brain and nervous system. Iodine is stored in the thyroid gland. It is recommended that women continue iodine supplementation during lactation, as breast milk will be the infant’s sole source of dietary iodine. Iodine-rich food sources that can help prevent a deficiency include; cod, dairy products, eggs, prunes and lima beans.
Iodine deficiency and conception
Iodine deficiency during the conception phase can lead to a decrease in fertility and may result in early miscarriage. Ideally, in planned pregnancy, routine thyroid screening tests, as well as a urinary iodine test, will be undertaken by your doctor to ensure adequacy and optimal function prior to conception.
Mild to moderate iodine deficiency during pregnancy may result in cognitive and neurological impairments of the infant. More severe iodine deficiency can result in maternal and fetal hypothyroxinemia, infant cretinism and mental retardation. Women with pre-existing thyroid conditions should consult their medical practitioner before taking an iodine supplement.
Choline
Choline is an essential nutrient that is required for the liver, muscle and brain to function properly. Choline is used for a number of physiological processes during pregnancy; including gene expression, membrane biosynthesis and tissue expansion, neurotransmission and brain development and methyl group donation. Arguably choline is just as important as folic acid. Rich food sources of choline include eggs, fish, nuts, cauliflower and broccoli.
Magnesium
Magnesium is an essential mineral in the body, involved in a variety of processes including; deriving energy from food, DNA synthesis, and blood sugar regulation. In addition, magnesium is a mineral component of bone along with calcium and phosphorus. Magnesium supplementation may also help prevent muscle cramps in pregnancy and may be helpful for headache prevention. Research is ongoing around magnesium and its impact on the risk for gestational diabetes and gestational hypertension. Pumpkin seeds, almonds and cashews are great sources of magnesium.
Zinc
Essential for embryogenesis (formation and development of an embryo) and spermatogenesis (formation and development of sperm), zinc is involved in up to 300 different enzymes within the body and is therefore in very high demand during both conception and early pregnancy. Zinc supports fertility by regulating normal hormone function, cell division and ovulation. As our bodies don't store zinc, it is important for women wanting to become pregnant to receive the recommended daily allowance. Legumes like chickpeas, lentils and beans all contain substantial amounts of zinc.
Probiotics
Not technically a micronutrient, but probiotics and fibre aids in building a healthy microbiome with a diverse range of bacteria that the mother and father will pass on to their baby. A pregnant mother’s microbiome releases molecules that make their way into the placenta and passes it on to their baby during childbirth and breastfeeding. With the microbiome playing such an important role in almost every aspect of our health, it is therefore very important that babies inherit the best microbiome possible.
The microbiome will develop during the first 2-3 years of life. Not having a robust and diverse microbiome can leave your child open to allergies, atopic diseases such as asthma, and digestive disorders not only in childhood, but throughout life.
