Preconception Planning - Part 2 - Prepare for Pregnancy with your Diet
Preconception Planning
Part 2 of a 3-part series
Prepare for Pregnancy with your Diet
This is an exciting time in your life, you are ready to try to get pregnant! Amongst all the excitement, there is usually a bit of fear and uncertainty about where to start. During the prenatal period my most frequently asked questions are all related to “what to eat?”.
There is a lot of mixed information out there on what foods to eat or avoid. The mixed information can lead to confusion, fear, and stress. Preparing for pregnancy doesn’t have to be stressful! My goal is to empower you to take charge of your health and be proactive about preparing your body for pregnancy. I am committed to supporting you from preconception to postpartum to build the family that you have always wanted. It is possible to establish sustainable nutrition habits during the prenatal period that will benefit you throughout pregnancy and beyond.
I recommend spending 3 months preparing for pregnancy in order to lay the foundations for optimum health prior to trying to conceive. For couples with a history of underlying health conditions, or if the mother-to-be has irregular menstrual cycles or has been on hormonal birth control for a number of years I recommend 6 months of preconception care. Often times in takes a few months to identify and undo old habits, and replenish missing nutrients in your diet. Carrying a pregnancy to term is a demanding process for your body. I want you to start the journey with a full tank of gas, not running on empty!
The preconception period is important for establishing the quality of your eggs (and his sperm), improving the ease at which you get pregnant, preventing unwanted side effects of pregnancy, and supporting the growth and development your baby. You have the unique opportunity to focus on optimizing the environment that will support your baby’s life from conception to birth. I target 5 pillars for prenatal nutrition: Macronutrient status, micronutrient status, gentle detoxification, blood sugar regulation, and antioxidant status.
DIET
Macronutrient Status
Protein - Protein is required for energy and energy-intensive processes in the body like making eggs and sperm. It is best to consume the majority of your protein from plant sources (beans, lentils, peas, nuts, seeds) and less of your protein from animal sources (meat, eggs, dairy) in order to enhance your fertility.
Fertility foods: lentils, beans, chickpeas, almonds, pumpkin seeds, hemp hearts, nut and seed butters, free range eggs, free range organic poultry, grass fed organic meat, wild Salmond, trout, mackerel, sardines
Servings: 3-4 servings a day; beans/lentils = 1 cup, nuts and seeds = 1/4 cup, nut/seed butter = 1-2 Tbsp, eggs = 2, meat and fish = 60-90 grams (or not more than the size of your fist)
Healthy fats - Incorporate unsaturated fats, including mono- and poly-unsaturated fats, into your diet. Reduce and avoid saturated fat by lowering animal products in your diet overall, and eating organic grass-fed animal meats in moderation. Omega-3 essential fatty acids (EFAs) are essential for the making hormones required for fertility and the development of the brain and nervous system your future baby.
Fertility foods: Walnuts, Brazil nuts, almonds, pumpkin seeds, sunflower seeds, sesame seeds, avocado, olives, extra virgin olive oil, ground flax seed, wild salmon, trout, sardines, mackerel, herring
Servings: 3-6 servings a day; oil = 1-2 Tbsp, nut/seed butter = 1 Tbsp, nuts and seeds = 1/4 cup, fish = 3 oz
Carbohydrates - There is a strong relationship between blood sugar regulation and fertility outcomes. The glycemic index (GI) is a measure of how much a food raises your blood sugar levels after a meal. Low GI foods cause a more subtle rise in blood sugar after a meal, keeping you feeling full longer, decreasing blood sugar swings and sustaining your energy levels. For this reason, choose carbohydrates that contain high fibre content and a low GI, and avoid refined sugars and foods with high GIs.
Fertility foods: Dark leafy greens, cruciferous and colourful vegetables, dark berries, apples, pears, brown rice, quinoa, whole oats, sprouted wheat, wild rice, millet, bulgur, amaranth, buckwheat
Servings: 6-11 servings a day (5-6 of those servings should be vegetables, and 1-2 of those fruit); lettuce/greens = 1 cup raw or cooked, vegetables = 1/2-1 cup raw or cooked, fruit = 1/2 cup - 1 piece; grains = 1/2 cup cooked; bread = 1 slice
Micronutrients Status
Folic acid/Folate - All women of childbearing age should meet or exceed the minimal daily requirements of 0.4mg per day. It is critical to have sufficient folic acid in your diet because very early in pregnancy folate is required for the development of the fetal neural tube, which will later develop into your baby’s brain and spinal cord. Folic acid deficiencies are associated with serious complications known as neural defects. The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends being on a multivitamin with folic acid for at least 3 months before trying to conceive. In addition to your prenatal vitamin, you should consume folate through a variety of food sources: dark leafy greens (kale, spinach, collard greens), broccoli, oranges, dried legumes, beans, and chickpeas.
Vitamin B-12 - This vitamin is important as it is involved in energy production and cell division. From supporting the development of egg and sperm cells, to the division of cells required for embryonic growth, this is a key nutrient for fertility and pregnancy. Make sure you are getting 2.4-2.6 mcg/day. Find vitamin B-12 in: squash, bell peppers, broccoli, sweet potatoes, carrots, eggs, wild fish, and grass-fed meat.
Iron - Higher iron intake is associated with increased fertilty. Though the recommended daily intake (RDI) is only 15 mg/day, and increases to 27mg/day in pregnancy, optimal fertility rates are seen in women who consume 40mg/day of iron. Food sources of iron include: chickpeas, lentils, quinoa, kale, broccoli, black strap molasses, and organic red meats. In generally iron is poorly absorbed. You can increase its absorption by consuming iron-rich foods with foods that contain vitamin C, and cooking with cast iron cookware.
Selenium - Selenium is a trace mineral that protects cells from oxidative damage, and is implicated in healthy thyroid function. Selenium requirements of 55mcg/day can be achieved through eating plant-based foods. Find it in: Brazil nuts, spinach, whole oats, lentils, eggs, and banana.
Vitamin D - Many, if not most, adults are deficient in vitamin D. Vitamin D is a vitamin and acts as a hormone in the body to support bone health, immune health, and mood. Food sources include alfalfa sprouts and nettle; drinking nettle leaf herbal tea is another great option. With the guidance of your physician, supplementing with 1000 IU/day of vitamin D3 is beneficial for most adults looking to enhance their fertility.
Gentle Detoxification
Support organs of elimination - Our bodies are designed with a built-in detox system. The main detox organs include the skin through sweat, the liver by metabolizing substances and preparing them for elimination through the kidneys as urine, and through the intestines as stool. In preparing for pregnancy most people do not need to do a cleanse. Simple ways to enhance natural detoxification include drinking plenty of water, eating fibre, and exercising regularly. Additional ways to support the liver and intestines include eating sour or fermented foods, liver supporting foods and herbs (leafy greens, broccoli, lemon, garlic, milk thistle, artichoke, dandelion, turmeric), and taking a probiotic. Talk to your doctor about whether gentle detoxification is right for you.
Detox your kitchen - The most effective way to detox, is to never be exposed to toxins in the first place. Identify toxins and chemicals in your kitchen and reduce your exposure to them. Eliminate plastic and BPA from your life including plastic food storage containers and plastic bags. Replace plastics with glass, porcelain, or stainless steel containers, and silicone or cloth reusable bags. Carefully read the label of canned foods for “BPA-free”, as most canned foods contain BPA in the lining of the can.
Organic - When it comes to fruits and vegetables organic is best. Choosing organic helps reduce your exposure to environmental toxins such as pesticides and glyphosate. Refer to the Environmental Working Group (EWG) website for a list of the “Dirty Dozen” to choose organic, and the “Clean Fifteen” which have lower levels of chemicals and are safe to choose non-organic. Consume organic, grass-fed meats, and choose skinless poultry to reduce your exposure to hormones, and toxins.
Alcohol - Alcohol is high in sugar and can increase inflammation and oxidative stress in the body. Though it is essential to completely eliminate alcohol in pregnancy, there is no harm in having small amounts of alcohol during the preconception period. Drink no more than 4 alcoholics beverages in a week, and no more than 2 per day. If you are actively attempting to get pregnant, refrain from drinking alcohol from 72 hours prior to ovulation until either a positive pregnancy test (and of course no alcohol going forward if you get a positive test) or your next period.
Caffeine - Reduce caffeine to less than 200mg/day. There is a greater risk of miscarriage in women who consumed >200mg of caffeine per day. Whether you drink coffee or tea, always choose organic so that you prevent exposure to pesticides that are found in high concentration in the non-organic counterparts.
Heavy metals like mercury - Eat small, wild caught fish, with short lifespans. These fish have lower levels of mercury compared to larger fish with longer lives to accumulate heavy metals. Do not eat farmed fish. Eat: salmon, trout, calamari, tilapia, sardines, achieves, herring. Avoid: tuna, halibut, swordfish, mackerel, marlin, pike, lobster.
Blood Sugar Regulation
Blood sugar balancing - Carbohydrates are the primary determinant of blood sugar and insulin levels. When blood sugar and insulin levels rise too high ovulation can be disrupted. Fast carbohydrates are those with high glycemic indices (GI); they are absorbed quickly and cause a rapid rise in blood sugar and insulin, followed by a sharp decrease in blood sugar. These types of foods (refined sugar, alcohol, candy, cookies, pastries, soda, chips) induce a quick burst of energy, followed by a drop in blood sugar that can leave you feeling hungry, dizzy, sweaty, and shaky. Contrarily, diets that include slow carbohydrates (low GI foods) are associated with improved fertility. Low GI foods include vegetables, brown rice, whole grains, and legumes. Blood sugar regulation is not about eliminating carbohydrates, but rather choosing the right carbs that will sustain balanced blood sugar and energy.
Food pairing - The GI of a meal can be lowered by mixing low GI foods with medium/high GI foods, adding a healthy fat, or including a sour food to your meal. Apple cider vinegar can be taken with a meal to decrease the rise in blood sugar following that meal. Examples of these food pairing include eating beans (low GI) with your rice (higher GI), putting a drizzle of extra virgin olive oil on your potatoes (because fat will slow the absorption of carbs), or using lemon juice or vinegar as a toping or dressing.
Insulin sensitivity vs. insulin resistance - Insulin sensitivity refers to the healthy state where insulin is released into the blood in response to a rise in blood sugar after a meal. Then this insulin helps shuttle blood sugar out of the blood and into the cells, to enable cells to carry out their normal functions. Insulin resistance describes the body’s reduced capacity to metabolize insulin and glucose. The pancreas must work harder to produce insulin and the insulin is less efficient at doing its job of transporting glucose (sugar) out of the blood and into the body’s cells. The excess glucose remains in the blood and contributes to pre-diabetes, weight gain, and disrupts hormones leading to ovulation irregularities. To maintain healthy sensitivity to insulin, it is important to eat a balanced diet with low-to-no refined carbohydrates.
Antioxidant Status
Oxidative stress and cellular inflammation - Oxidative stress or cellular inflammation is the root cause of premature aging and disease. Foods that are high in free radicals or cause inflammation include: processed foods and “fast food”; high AGE (advanced glycolation end products) from sugar and protein cooked together at high heat (eg. meat bbq’d in sweet sauce); high fructose corn syrup (HFCS) found in soda pop and processed foods; trans fats and fried foods; artificial colours, flavours, sweeteners, or preservatives; white flour and products made from flours (bread, muffins, pancakes, cookies); refined vegetables oils which are high in omega-6 fatty acids; and moderate and high GI foods (white bread, bagels, crackers, refined cereals, juice). Eliminating these foods decreases oxidative stress and inflammation that can damage your cells and the DNA of your eggs and sperm.
Antioxidants and anti-inflammatory - A diet rich in antioxidants plays a large role in preventing cellular inflammation and oxidative stress. Choose antioxidant-rich foods by looking for dark leafy greens, dark or deeply pigmented and brightly colourful fruit and vegetables. The Mediterranean diet is an anti-inflammatory diet which has been proven to be associated with lower rates of disease and illness. Oxygen radical absorption capacity (ORAC) is a term to describe the antioxidant activity of a particular food. Higher ORAC scores indicate foods with the highest capacity to neutralize oxidative stress and cellular inflammation. Include high ORAC foods into your diet such as: alfalfa, apple vinegar, applesauce, asparagus, avocado, basil, beans, beets, bell peppers, black pepper, blueberry, blackberry, broccoli, Brussels sprouts, cherries, chili powder, cilantro, cinnamon, cloves, cocoa, cranberry, dates, eggplant, elderberry, figs, Fiji apples, ginger, green tea, extra virgin olive oil, kale, nuts, oatmeal, oranges, oregano, parsley, peaches, pears, plums, pomegranate, prunes, purple cauliflower, purple sweet potato, raisins, raspberry, red cabbage, red grapes, red leaf lettuce, red potatoes, spinach, strawberry, tangerines, and turmeric.
By ensuring that you are eating a balanced nutrient-dense diet during the preconception period you will optimize your individual health. In addition, you will enhance the quality of your eggs, improve your fertility, and prevent nutrient deficiencies to support the growth and development of your future baby. Use these prenatal nutrition guidelines and book a preconception care appointment in order to prepare for your pregnancy.
Take care,
Dr. Laura Nicholas, ND
This content is not intended to be substituted or interpreted as medical advice and should not be used to diagnose, treat, or prevent any disease or health concern. Please book a consultation with me or a qualified healthcare professional before acting on any information presented here.
References
Chavarro, J.E. and Willett, W.C. The Fertility Diet. New Findings from the Nurses’ Health Study. New York, NY, McGraw Hill, 2008.
Foster, W.G. and Agarwal, S.K. Environmental Contaminants and Dietary Factors in Endometriosis. Ann N Y Acad Sci. 2002 Mar; 955:213-29; discussion 230-2, 396-406.
Health Canada. Nutrition for a Healthy Pregnancy. Nutrition Guidelines for the Childbearing Years. Ottawa: Minister of Public Works and Government Services Canada, 1999.
Tori Hudson. (2008). Women’s Encyclopedia of Natural Medicine.
Society of Obstetricians and Gynaecologists of Canada. SOGC Guidelines. Retrieved from https://sogc.org/en/content/guidelines-jogc/guidelines-and-jogc.aspx?hkey=aa09f753-7812-462a-9d80-3e6b609f6ec6.