pre-pregnancy nutrition (part I)

Why is pre-pregnancy nutrition important?

While arguably pregnancy nutrition is most impactful for the baby’s development, pre-pregnancy nutrition can set up habits and priorities that carry into pregnancy for beneficial effects – for both you and your baby!

Too much maternal weight gain during pregnancy is risky, for both the baby and mother. There are also risks associated with inadequate weight gain.

• Inadequate weight gain increases a woman’s risk of having a low birth-weight baby and raising the child’s odds of developing numerous health problems and disabilities.
• Gaining too much weight during pregnancy are at a higher risk of having large babies, infants with low Apgar scores, cesarean section delivery, and postnatal weight retention.

Long term, a poor diet during pregnancy may put your baby at risk for obesity, insulin resistance, type 2 diabetes, and cardiovascular disease later in life.

What are some habits that can help set up good pre-pregnancy nutrition?

Exercise regularly. Exercising regularly can improve cardiovascular function, increase muscle mass, and help maintain weight and emotional stress, all of which will benefit your health if you’re thinking of getting pregnant, or are simply wanting to improve overall health. However, if you’re exercising too strenuously without providing proper nutrition, low body weight and reduced body fat are related to reproductive problems, such as infertility. One red flag is that menstrual cycles are infrequent, or even stop altogether.

Focus on healthy fats and fatty acids. Healthy fats, in particular DHA, has a growing body of evidence that supports the baby’s brain and eye development. During pregnancy, women should consume at least 200 mg DHA per day, which is achieved by eating 1 to 2 servings of low-mercury seafood (salmon, per week. Aim to focus intake on nuts, seeds, avocados, and plant fats like olive oil.

Add antioxidants in the form of food daily. Certain vitamins and minerals are beneficial for fertility like folate and zinc. Free radicals can cause problems associated with sperm motility, sperm number, DNA damage in sperm, and development of the female reproductive process, from egg production to ovulation. Instead of stressing that you or your partner has been exposed to these free radicals, opt for a more a reasonable approach by simply increasing your fruit and vegetable intake. We are exposed to free radicals constantly, but by eating fruits like berries, oranges, pineapple and pomegranate, and vegetables like spinach/dark leafy greens, peppers, mushrooms, beets, broccoli, and artichokes, you can give your body what it needs to fight off oxidative stress. Healthy fats provide sources of vitamin E, which is another key antioxidant. Nuts and seeds are excellent sources of vitamin E.

Combat emotional stress in a healthy, productive way. Stress unfortunately causes cortisol to rise, leading to a disarray in metabolic function. Take inventory on stress levels and prioritize your mental health as well as managing any stress you may have.

Be mindful of cravings and food habits during your menstrual cycle. Hormonal changes are largely associated with cravings. When estrogen is low, and progesterone is high, it’s possible to feel increased cravings and less satisfied after eating. However, just because these fluctuations in hormones are happening, doesn’t mean you have a lack of control over the subsequent behavioral response.

• There are chemical pathways that can be triggered in the brain in response to eating certain foods. “Cravings” and “food addiction” are not synonymous, and there is a lack of evidence that suggests “food addiction” exists. However, we do know that hyperpalatable foods and addictive substances can cause imbalances in the brain’s system. Repeated consumption of highly palatable foods to produce pleasure or calm emotions triggers the release of dopamine, which can condition the brain to seek out this chemical pathway, causing you to repeat the food behavior.
• Knowing that your body is responding in this way can help you make an educated food decision. Highly palatable foods are those that are ultra-processed, fast food, and desserts (i.e., high fat and high sugar). You have the opportunity to change brain signaling by being aware of your body’s response and choose a different food behavior.

Have lipid blood levels, vitamins and health indicators checked regularly, as your physician recommends – know your familial risk for cardiovascular disease, diabetes (insulin resistance), high blood pressure, PCOS, and osteoporosis. This also goes without saying to check your medications, herbal supplements, and other supplements. Certain ingredients are contraindicated during pregnancy, and if possible, discontinue use long before you get pregnant to avoid any deleterious effects on the growth of the baby. Some ingredients take longer to exit your body’s system. Knowing your health conditions can help you adequately prioritize the right nutrition interventions for your baby’s health and gestation.

*Also, my classic sports dietitian recommendation is to avoid using any supplements that aren’t third party tested or recommended by your dietitian and physician. The supplement industry is not regulated, and you could unknowingly be consuming a harmful substance to your body which might affect your baby.

Avoid alcohol and smoking. Alcohol consumption increases the likelihood of a miscarriage. And it also can be found in semen shortly after drinking, possibly interfering with implantation and fertilization. While repercussions are seen as more deleterious during pregnancy, if you and your partner are serious about conception, choose to drink during your period – when ovulation is less likely. Additionally, women who smoke take twice as long to conceive and it causes men to have a lower sperm count.

• Both increase oxidative stress in the body, an environment that makes it harder to conceive.

Pay particular attention to specific nutrients. Micronutrients like iron, vitamin B12, folate, vitamin D, iodine are especially needed in higher amounts potentially during pregnancy, so having levels checked before can be beneficial. Supplementation might be necessary, but in the stages before pregnancy, prioritize food sources. Foods like green leafy vegetables, cabbage, legumes, whole grains, tomatoes and oranges are good sources of folate (5).

Things to Think About.

All of this information is meant to spark interest and provide things to think about. Rather than worrying about what all could go wrong, or trying to get it perfect, instead consider the opportunity to choose every bite for the best – for your body and your baby’s!

• Strive for balance and variety
• Trash the junk food
• Be inspired by the good you can do for your little one!

BEFORE you start taking a supplement, ensure you check with your physician and dietitian for safety and efficacy. There are a ton of supplements out there, and some truly aren’t safe for pregnancy or even pre-pregnancy.

A balanced diet that is high in fruits, vegetables, lean protein, low fat dairy and healthy fats is superior to overloading on supplements.

During pregnancy, your body will have increased needs of certain micronutrients and macronutrients, which is why it’s important to choose to consume the healthier options of foods rather than junk. Even though you’ll need to gain weight, and thus need to eat extra calories, choose to provide nourishing foods for yourself and your little one to optimize healthy growth and weight gain.

Sources:

1)	From <https://www.todaysdietitian.com/newarchives/121311p30.shtml>
2)	From <https://www.todaysdietitian.com/newarchives/050113p38.shtml>
3)	Cravings | The Nutrition Source | Harvard T.H. Chan School of Public Health
4)	Jouanne, M.; Oddoux, S.; Noël, A.; Voisin-Chiret, A.S. Nutrient Requirements during Pregnancy and Lactation. Nutrients 2021, 13, 692. https://doi.org/10.3390/nu13020692
5)	Ann Nutr Metab 2019;74:93–106 95 DOI: 10.1159/000496471