Preconception Nutrition

Men's Health, Women's Health, Pregnancy | January 12, 2017 | Author: Naturopath

pregnancy

Preconception Nutrition

Considerable evidence reveals that nutritional status and lifestyle choices of both male and female before pregnancy can have a profound impact on future offspring health.

Preconception Health for Men and Women

Eat a well-balanced diet.
It is recommended that mums use the 3-4 month pre-conceptual window to boost their nutritional status, and optimise their health and well-being before conception. As new sperm is made every 42-76, dads should maintain a similar diet for 3 months in order to improve sperm quality. This diet should include plenty of plant sources (vegetables, fruits, legumes, nuts, seeds, and whole grains), along with some fish, poultry, dairy products, eggs, and with little consumption of lean red meat.

Be aware of your biological clock. One in six Australian couples have problems conceiving, according to the Department of Health. Age is one of the factors affecting fertility.
More and more women are choosing to have children at an older age, yet fertility is thought to decline once a woman passes the age of 28. The chance of having a healthy baby also decreases with age. Being an older mother, typically over the age of 34 years, increases the risk of having a baby with a birth defect, while fathers over the age of 40 have a 20% greater chance of having a baby born with a serious birth defect.

Avoid cigarette smoking and excessive alcohol consumption. The World Health Organisation states that eliminating smoking before or during pregnancy could avoid 5–7% of preterm-related deaths and 23–24% of cases of sudden infant death syndrome. Smoking affects the quality of the eggs and sperm, and together with alcohol, both reduce men and women fertility.

Limit your caffeine consumption. High daily intake of caffeine (>300mg/d or ore than 2 cups of coffee per day) of both partners significantly increases the risk of miscarriage.

Avoid the use of recreational drugs and certain medications. For example, women should avoid exposure to teratogenic substances such as Accutane, and anti-seizure medications as they interfere with normal organ development, while men should avoid drugs that include steroids to prevent damage to sperm DNA. Furthermore, recreational drugs have also been linked to male infertility.

Maintain a healthy environment. Long term exposure to work-related chemicals, such as dyes, solvents, weed killers, as well as pesticides and cosmetics can affect a woman’s safety and ability to conceive, as well as cause DNA damage to the sperm, resulting in infertility or birth defects.

Exercise. Regular exercise is beneficial for weight loss, emotional well-being, and even fertility.

Reduce your stress. Maternal stress is associated with Infertility, miscarriages, late pregnancy complications, and impaired foetal development.

Acute stress has been shown to affect sperm quality.

 

 

Optimise pre-pregnancy weight. Women who are underweight before pregnancy (BMI under 18.5) are at significantly greater risk of preterm birth and small-for-gestational age babies. Additionally, it is suggested that maternal undernutrition is associated with increased risk of obesity and related chronic diseases of her offspring in later life.Similarly, maternal overweight and obesity preconception is linked to infertility and complications during pregnancy including gestational diabetes, preeclampsia, and delivery complications, as well as increased range of health risks for the offspring. Male obesity decreases male fertility.

Special Concerns for Mothers

Eating fish - Fish is rich in fatty acids that are essential to brain development. However, some women are concerned about mercury, which in high doses can harm developing nervous systems. 
Food Authority recommends that pregnant women and women who are planning pregnancy limit consumption of catfish, orange roughy, shark and billfish (swordfish, marlin).
It is safe to eat fish that are lower in mercury, such as mackerel, salmon, snapper, trevally, herring and sardines 2-3 serves per week.

Prenatal vitamins. During pregnancy, your daily intake requirements for certain nutrients will increase. It is therefore important to achieve and maintain adequate nutrient status prior to conception. Vitamin and mineral deficiencies in the mother lead to deficiency in the foetus and newborn.

Common nutrient deficiencies in women that may require supplementation include:

  • Folic acid – this is the synthetic form of folate used in supplements and fortified foods. Supplementation with folic acid is universally recommended to women to prevent the occurrence of devastating birth defects called neural tube defects. The defects occur between the 21 and 28 days following conception, a time when many women do not realise they are pregnant, and therefore all women who could become pregnant should take 500µg/d (0.5mg) folic acid prior to conception and for the first three months of pregnancy.
     
  • Iodine – the Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends 150mcg iodine pre-pregnancy, during pregnancy and while breastfeeding for your baby’s brain development.
     
  • Iron – Iron deficiency is the most common nutritional deficiency worldwide. Based on data from a population based study in Queensland, 10.6% of females aged <50 years have low iron stores, possibly as a result of menstrual blood losses and/or poor diet. Iron is essential for blood production and oxygen transport, and maternal iron deficiency anaemia is associated with a greater risk of low birth weight, premature delivery and increased maternal mortality.
     
  • Calcium - calcium supplements may be necessary for women who have difficulty consuming enough calcium from food. Calcium is critical for building and maintaining bone, and it is therefore important to build adequate body calcium stores and prevent bone loss during pregnancy. Low calcium intake is also implicated in abnormal high blood pressure in pregnancy.
     
  • Vitamin D - vitamin D deficiency in pregnancy has been associated with an increased risk of preeclampsia, gestational diabetes, preterm birth and low birth weight.
     
  • Vitamin B12 - Low vitamin B12 status is a risk factor for preeclampsia, premature delivery, low birth weight, neural tube defects, and stillbirth. As vitamin B12 is only found in animal food-sources, dietary intake may be very low in women who follow vegetarian diets and non-existent in vegan diets. It is recommended that these women supplement before and during pregnancy.

Special Concerns for Fathers

Men produce over 12 billion sperm per month. Thus, in order to increase the chance of conception and ensure a healthy DNA, it is vital for the male partner to optimise his sperm quality,

  • Testicular hyperthermia. The temperature of the surrounding scrotal sac affects the temperature within the testes. Heat stress to the scrotal area causes the production of lower quality sperm thus affecting fertility. Ways to reduce scrotal temperature include:
  • Wear loose clothing
  • Avoid a long period of predominantly sedentary or seated position such as working at the computer
  • Limit the use of hot baths and sauna
  • Place your laptop on the desk rather than on your lap
  • Lose weight. Obese men have a compromised testicular heat regulation.
     

Prenatal supplements for men:

  • Antioxidants. Antioxidants are the main defense against damaging effects of oxidative stress on sperm. A 2011 review of 34 trials with a total of 2876 couples found that male antioxidant supplementation was significantly associated with increased pregnancy rate and greater odds of a live birth. Antioxidant vitamin and minerals include beta-carotene, vitamin C, vitamin E, and selenium.
     
  • Essential fatty acids. Studies suggest that infertile men have lower concentrations of omega-3 fatty acids in their sperm than fertile men.
     
  • Zinc. Zinc is found in high concentrations in both the male reproductive organs and sperm, and lower zinc status has been linked with ale infertility.

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References

Australian Government Department of Health 2011, Fertility and infertility, retrieved 11 January 2017, < http://www.health.gov.au>

Blanco, C., Echeverry, C., Kiserud, T., et al (2015). The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”#. International Journal of Gynecology and Obstetrics, 131, S213–S253.

Cragan, J. D., Friedman, J. M., Holmes, L. B., et al. (2006). Ensuring the safe and effective use of medications during pregnancy: planning and prevention through preconception care. Maternal and Child Health Journal, 10(5 Suppl), S129-35.

De-Regil, L. M., Peña-Rosas, J. P., Fernández-Gaxiola, A. C., & Rayco-Solon, P. (2015). Effects and safety of periconceptional oral folate supplementation for preventing birth defects. In L. M. De-Regil (Ed.), Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd.

Dean, S. V, Mason, E., Howson, C. P., et al. (2013). Born too soon: care before and between pregnancy to prevent preterm births: from evidence to action. Reproductive Health, 10 Suppl 1(Suppl 1), S3.

Department of Primary Industries, Food Authority 2016, Mercury and fish, retrieved 11 January 2017,

Durairajanayagam, D, Agarwal, A & Ong, C (2014). Causes, effects and molecular mechanisms of testicular heat stress, Reproductive BioMedicine Online (2014), doi: 10.1016/j.rbmo.2014.09.018

Ebisch, I.M.W, Thomas, C.M.G, Peters, W.H.M et al. (2007), The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility, Hum. Reprod. Update (March/April 2007) 13 (2): 163-174.

Frey, K. A., Navarro, S. M., Kotelchuck, M., & Lu, M. C. (2008) The clinical content of preconception care: preconception care for men. AJOG, Supplement to DECEMBER 2008

Lassi, Z. S., Imam, A. M., Dean, S. V, & Bhutta, Z. A. (2014). Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure. Reproductive Health, 11 Suppl 3(Suppl 3), S6.

Nakamura, K., Sheps, S., & Arck, P. C. (2008). Stress and reproductive failure: past notions, present insights and future directions. Journal of Assisted Reproduction and Genetics, 25(2–3), 47–62.

Phd, F. A., Coyne Phd, T., Dobson Phd, A., & Mcclintock, C. (2008). Iron status among Australian adults: findings of a population based study in Queensland, Australia. Asia Pac J Clin Nutr, 17(1), 40–47.

Showell, M. G., Brown, J., Yazdani, A., Stankiewicz, M. T., & Hart, R. J. (2011). Antioxidants for male subfertility. In M. G. Showell (Ed.), Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists 2016, Planning for Pregnancy, retrieved 11 January 2017

World Health Organization 2013, Preconception care policy brief, retrieved 11 January 2017,

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