Dietitian Aoife Hearne on the importance of nutrition before conception.
I’M at that stage in pregnancy where people are willing to risk asking me how far gone I am. And every single time I need to think about it for a minute.
On my first pregnancy, I knew to the day how far along I was — now life is much busier and the weeks are just flying by. At the last count, I am 26 weeks pregnant with my third baby and life without babies seems like a very distant memory.
I am one of the lucky ones, who really didn’t have that much trouble conceiving and I thank my lucky stars every day. It is estimated that one in six couples in Ireland has difficulty conceiving, with infertility officially defined as not conceiving after one year of unprotected intercourse.
There are many factors that affect fertility, including age, body weight, diet, smoking status, or exposure to tobacco smoke, stress, alcohol consumption, exercise, environmental chemicals, medications, and street drugs such as cannabis and cocaine.
The internet is bursting with information regarding nutrition advice for women who are trying to get pregnant and often it’s difficult to cut through the quackery. It may be obvious but avoiding following an overly restrictive diet is important.
In 2010, the Nurses’ Health Study in the US followed 18,500 female nurses over an eight-year period, who reported on their lifestyle and fertility, among other areas.
Led by Dr Jorge Chavarro and Dr Walter Willett from Harvard Medical School, they went on to identify 10 practical and low-tech ways to optimise pregnancy.
1 Avoid trans fats as they are a powerful deterrent to ovulation and conception
Trans fats can be found in processed baked foods — check food labels for trans fat or partially hydrogenated oils.
2 Use unsaturated vegetable oils
Monounsaturated and polyunsaturated fats help improve the body’s sensitivity to insulin and reduce inflammation, both good for fertility. Use unsaturated oils such as olive oil and include foods such as nuts, seeds, and cold water fish (salmon and sardines) regularly. Cut back on animal fats that have a high saturated fat content such as cheese, cream, and butter.
3 Eat more vegetable protein like beans/nuts and less animal protein such as red meat
Protein can influence blood sugar and insulin sensitivity as well as insulin-like growth factor. Aim to have protein at each meal and snack.
4 Choose wholegrains and other higher fibre sources of carbohydrate
Carbohydrates increase insulin production in the body which in turn influences the amount of sex hormone binding globulins which impacts fertility. Refined carbohydrate choices such as white bread/rice/pasta/cereal have fewer B vitamins, iron, vitamin E, and fibre, all of which are important for ovulation and conception. Higher fibre sources such as wholegrains, potatoes, oats, wholewheat pasta/cereal, fruit, and veg are your best choices.
5 Drink a glass of whole milk or full-fat yogurt every day
Interestingly women who had a glass of whole milk/yogurt daily had less difficulty getting pregnant. This is thought to be due to the fact that the higher fat content of full-fat milk can curb appetite and slow the release of sugar into the bloodstream.
6 Take a multivitamin daily that has folic acid (400mcg-700mcg/day) and iron (40mg-80mg)
As both of these microminerals are essential for ovulation, conception, and sperm production. Folic acid before pregnancy is also important in helping to preventing birth defects that happen at three to four weeks of pregnancy, in particular neural tube defects such as spina bifida.
7 Eat plenty of iron from fruits, vegetables, beans, and supplements (40mg-80mg/day) and less from red meat
Vegetarian foods with iron include all types of beans, eggs, lentils, spinach, fortified cereals, long-grain enriched rice, and whole grains. Add vitamin C from citrus fruits, bell peppers, or berries to your meals to enhance iron absorption.
8 Beverages matter
No surprises that water is the champion when it comes to beverages. It doesn’t mean you have to avoid tea/coffee, but aim to limit these to fewer than five cups a day. It is recommended to avoid fizzy drinks and highly caffeinated energy drinks completely.
9 Weight matters for both partners
Being overweight or underweight can impact negatively on ovulation and conception. If both partners are overweight, the likelihood that it will take more than a year to get pregnant increases. But there’s good news: many studies show that overweight women have great success in conceiving once they’re closer to their ideal body weight. In fact, according to the American Society of Reproductive Medicine losing just 5% to 10% of total body weight can dramatically improve ovulation and pregnancy rates.
10 Exercise in moderation
If you aren’t active, start and if you are active, up the pace, but avoid high-intensity exercise on a regular basis. Aim to exercise five days a week for 30 minutes.
While there is a lot of focus on what women eat to fuel fertility, it is also really important to recognise that it does take two to tango and having a healthy partner, following similar eating habits, is just as important.
What else can you do?
* Avoid smoking. Women who smoke take twice as long to conceive and are more likely to have a miscarriage. Cutting out smoking completely is a wise decision to make, both for reproductive health and for overall well being.
* Reduce alcohol intake. Alcohol can reduce chances of getting pregnant, therefore cutting back to the bare minimum of alcohol intake for both partners is a good plan of attack.
* Get screened for coeliac disease. This is an autoimmune disorder where the body can’t break down gluten. While it is relatively rare, affecting only 1% of the population, it affects more women than men and has been shown to reduce fertility.
* Check for polycystic ovarian syndrome, caused by an imbalance of hormones — especially insulin. It affects as many as 10% of women and the majority of those women are thought to have fertility issues.