PREPARING FOR PREGNANCY
A woman is born with all of her eggs but it is the maturation process that occurs 3-4 months before she ovulates that significantly influences the health of the foetus and eventual child. There are countless studies indicating that nutritional deficiencies, illness, toxin exposure and other factors all influence the health of the egg up to a minimum of 100 days prior to ovulation.
Just as we plan for a wedding, so too should we plan for one of the most important decisions of our life – having a baby. Whilst good health is important throughout one’s pregnancy it is essential that we consider the time before pregnancy.
It is just as important to remember that fertility is something for the couple to work on together. The male's role is just as important. Sperm take on average 72-76 days to develop, mature, be stored and finally ejaculated. As such, a man's health 2-3 months prior to conception can significantly influence pregnancy outcomes. Similarly to females, a male should prepare during this preconception period to ensure the best information is passed on through their sperm.
There are alarming statistics regarding miscarriage, stillbirth, infertility, increased prematurity and other concerning considerations, which are believed to have been caused by our modern lifestyles. Environmental pollution, poor nutrient levels in soil and foods, polluted water, toxic farming methods, heavy metal exposure, poor diet, lack of exercise, and many others are all believed to be involved.
It is important to remember that we all have choices and that we can choose to make changes that will not only improve our health but the subsequent health of our children and future generations.
An easy way to think about it is to treat your body as though you’re already pregnant at least 3-4 months before you actually fall pregnant.
Important key areas for preconception health are:
· Ensure that you drink enough water and have adequate hydration
· Encourage (or start) regular exercise – aim for at least 30-40 minutes per day
· Reduce stress levels as much as possible both in your work, home, emotional state and environment
Dietary
Be conscious of what you put into your mouth and what is in your environment. Any toxin exposure can and will influence your gametes (eggs and sperm). Sperm are even more vulnerable than eggs to toxic exposure and nutritional deficiency. Organic foods are higher in nutrients and are free from harmful pesticides, herbicides, fungicides and other chemicals.
Weight stabilisation
Clean up your diet and reach your healthy weight range. Being under or overweight can contribute to reduced fertility outcome.
When someone is underweight, it can compromise their nutritional status and subsequent nutrient delivery to their child. If a female is considerably underweight, she may not ovulate successfully, which understandably compromises her fertility.
Excessive weight is challenging for multiple reasons. Anyone that is overweight knows that his or her body simply doesn’t function the way it should. They are acutely aware of restrictions of obvious signs such as reduction to breathing or fitness or are aware of subtle changes such as increased sebum production on the skin or digestive difficulties and poor nutrient absorption. It is also important to remember that fatty tissue stores toxins. Often people will try to lose weight but it simply won’t shift due to toxin accumulation in adipose (fatty) tissue. Supporting the organs of elimination including the liver, digestive system and urinary system enables detoxification and clearance.
Avoid recreational, environmental and medication derived toxins
Pre-pregnancy is not the time to continue bad habits. Countless studies link alcohol, drugs, some medications, caffeine and smoking with birth defects, miscarriage and reduced fertility. It is important to focus on wellbeing and optimal health.
Male-specific
Protect the testicles (sperm production sites) from excessive heat
· Wear loose cotton boxer shorts
· Avoid spas and saunas
· Avoid wetsuits (surfing)
· Avoid tight bike shorts and bike riding
Reduce radiation exposure
Radiation comes from simple things like mobile phones, wireless connectivity or aeroplane travel. By simply reducing how much time you speak on your mobile and turning it off at night and/or leaving it in another room. Turning wireless modems off at night is also a good idea and make sure – men especially – don’t walk around with mobile phones in your pocket.
In the preconception period, it’s optimal to reduce your flight travel and obviously in the first trimester reduce (or avoid if possible) as well. Ideally, it is best to remove all radiation sources from the bedroom, especially. Get rid of the alarm clock, TV and bedside lights and go back to basics – use candles in the bedroom and book lights (battery powered) for reading. Just think about the effects of the power cords running under the bed while you sleep… Once you try it without you’ll never go back!
A healthy body is a fertile body
Build up your nutritional status and consider seeing a healthcare practitioner for a tailored dietary plan and supplement regime. Establishing good nutrition before you conceive helps both you and your baby be as healthy as possible throughout the pregnancy and beyond.
When you consider the concept that you ‘are what you eat’ it is no surprise that a healthy, balanced and nutritionally optimal diet is recommended both pre-conceptually and during pregnancy. Supplementation is essential in some instances but if you eat a rubbish diet there is no amount of vitamin supplementation that can change that. At some point, we need to acknowledge that the block of chocolate (for example) is bound to have a negative effect. Ultimately what can your body do with this food? The concept of being realistic is essential as no one should completely deprive himself or herself of everything, however, moderation is the key. Use the general rule of 90% for your body and 10% for treats. This means eat well at home, spend time shopping for good food and then when you’re out with friends it’s okay to have the ice-cream at the movies or that piece of birthday cake.
Now that we’re clear on the general principles, let’s review a few keys areas that should be considered for all couples in the preconception period.
Eat organic as much as possible
Now I know that a lot of people wonder if this is really worth the expense. All of the top chefs in the world can’t be wrong. Organic food simply tastes better. I know from personal experience that my sense of satiety is greatly increased when I eat organic vs. non-organic foods. It’s almost as though my body wants more food simply to try to reap more nutrients.
Above all, if organic eating means you’re rationing excessively (i.e. rationing one tomato for a whole week) then perhaps you’re not going to get the right amount of nutrients regardless. Be logical about your decisions. Organic potato chips are minimally healthier (they’re still fundamentally potato chips), however, organic peaches are markedly different than their non-organic counterparts.
If you can eat 100% organic – fantastic and please do! If not, perhaps focus on priorities such as meat, dairy, eggs, and as many fruits and vegetables as you can. Remember though that organic mincemeat or sausages is not a better choice than non-organic eye fillet. Each decision should be considered carefully and objectively. Try to work out what you are trying to achieve. Perhaps the increase in protein and reduction in saturated fat from the eye fillet is a better choice?
Protein requirements
Building a baby takes lots of nutrition and building healthy gametes (sperm and eggs) requires ample protein for its infrastructure. Have a look at your diet objectively and perhaps write it down for one week, and then assess.
Protein comes from either animal or vegetarian sources. Animal sources include red or white meat, fish, eggs, or dairy products. Vegetarian sources include wholegrains (each grain varies significantly), nuts, seeds, pulses and their sprouts. Of importance, remember that each food you consume will be a combination of all of the macronutrients i.e. it will comprise of carbohydrates, protein and fats. The concept of pure protein in foods is complicated and there are some minor exceptions for a general diet, acknowledge this aspect.
Each protein comprises of a series of amino acids and it is the amino acid arrangement that determines the number of qualities. For example, animal sources of protein breakdown to provide all of our amino acids and are considered a complete protein. Vegetarian sources break down to provide some of the amino acids are often deficient in some. The trick to healthy eating is to combine a number of vegetarian sources together such as hummus, falafel, tabouli and pita or lentils and brown rice as the combination provides a more balanced source thus supporting optimal protein usage in the body.
When you consider your protein requirements it is calculated based on your weight and level of activity. As a general rule, we use the calculation of 0.8-1.2g/kg body weight where 0.8g/kg is used if someone is less active (but not sedentary) and 1.2g/kg is used for individuals with active lifestyles and regular exercise. Most individuals can use the 1g/kg calculation as a general rule. However, it is advisable for a naturopath or similar to review this comprehensively to assess your individual requirements. As such, the average 60kg woman with average activity would require approximately 60g protein per day. So 200g full-fat yoghurt would generally provide 20g of protein. Start to read labels and understand that each food has varying protein content and review what you’re eating.
Caffeine
I doubt that anyone is surprised to see this included in the recommendations! Caffeine has been proven in countless studies to negatively affect fertility with one study suggesting that it reduced a person’s monthly chance of conceiving by greater than 45% when consumed in doses higher than 250mg/day.
Caffeine consumption has been linked to causes of infertility including endometriosis and an increased risk of spontaneous abortion. Excessive intake of caffeine is also likely to place stress on the adrenal glands reducing a person’s natural stress management thereby increasing stress hormones and chemicals that cause negative effects to health and fertility. Additionally, its diuretic action will impact on nutritional status and increase the loss of vital nutrients required to enhance fertility such as B vitamins. In one paper, it was observed that women who consumed less than one cup of coffee per day were twice as likely to become pregnant compared with moderate coffee drinkers (2-4 cups per day). It was concluded that the risk of failing to become pregnant increased with higher consumption. As such, it is essential for both partners to avoid caffeine in those trying to optimise their fertility.
Alcohol
Alcohol is never considered a health-promoting substance, and in the realm of fertility, there is no exception. As the general principle is to improve health overall alcohol avoidance is recommended. There are mixed reports as to the extent of its effect, but it is generally agreed that it has a negative impact on fertility.
One interesting paper reported reduced conception from as little as one drink per week and observed a 50% reduction in the probability of conception during a woman’s cycle when females consumed alcohol. Other literature has shown links with increased risk of miscarriage, negative effects on egg quality and lower chance of subsequent pregnancy. Alcohol is believed to slow the ability of the embryo to mature and implant and significantly increase one hormone oestrogen. This hormone when high at the wrong time in a woman’s cycle reduces or delays the ability for natural ovulation and is a common cause of those love handles and extra-abdominal weight.
Now the men are not immune and cannot think that they are safe! Alcohol consumption in men is associated marked effect to sperm both with defective sperm shapes, poor swimming ability and reduced count.
Trans fatty acids
We all know that trans fats are nasty fats for a number of reasons. One interesting paper discovered that trans fats may increase the risk of ovulatory infertility, particularly when consumed instead of carbohydrates or unsaturated fats. This is a scary proposition and reminds women to stay away from these fats completely to protect their fertility and improve their fertile outcome. Main dietary sources of trans fats are packaged foods such as biscuits, cakes, etc and watch out for ‘vegetable fats’ on ingredients of packaged foods as it typically means that it is a poor quality vegetable fat such as cottonseed or soy oil, or it’s a healthier fat such as sunflower oil that has been modified in structure to stay solid at room temperature thus making it a trans-fat. As a general rule avoid processed foods as much as possible but completely avoid these trans fats for an optimal outcome.
The fertility diet
A healthy wholefood diet is one that naturally encourages fertility. The concept of a fertility diet is not new. There is significant research suggesting that dietary modulation improves ovulation, conception and the birth of a healthy child.
One really interesting paper reviewed the concept of a fertility diet in significant detail. What was found was that a positive fertility diet consisted of:
· Low/no intake of trans fats with a simultaneous greater intake of monounsaturated fat
· Lower intake of animal protein with greater vegetable protein intake
· Higher intake of high-fibre, low glycaemic carbohydrates
· Greater preference for high-fat dairy products as opposed to low-fat highly processed versions
· Higher non-heme iron intake (vegetarian sources of Iron)
· And a higher frequency of multivitamin use
From these above observations, it was concluded that the positive dietary modifications correlated with a positive fertility outcome. As such the “fertility diet” pattern is seen to have positive effects on the fertility of otherwise healthy women and that combining this dietary strategy with bodyweight control and increased physical activity may help prevent the majority of infertility cases due to problems with ovulation.
The most important consideration is to treat your body as though you are already pregnant (easily done for women) and for men to acknowledge that they provide 50% of the genetic material for their future little one so self-responsibility and self-care are both vital.
Remember, the gift of preconception care is that it allows you to start being the parent you want to be even before the little one arrives.
If you are interested in preconception care, I would be delighted to work with you! Please book an appointment here